Medical Ethics and its various problems

I recently finished this book called "First do no harm" by Lisa Belkin. It's a quick read with some melodramatic prose regarding the work of a particular ethics committee at a Texan hospital.

Some of the issues facing the committee were: whether to operate on a patient or let "nature take its course." Whether to keep a patient or ship him off to another hospital. Whether to let a patient go DNR (Do not resuscitate) or to save him whenever possible.

As I read this book, I realize more and more that I'm much more of the "let nature take its course" kind of person. Perhaps that is not surprising, given my personality, but more so than personality, it really is a personal philosophy as well. Sometimes when physicians do all they can to "save" a person, they truly do end up doing much more harm than good. You see a patient lying inert on a bed, four or five tubes sticking out of the person at various orifices, with complex lines crisscrossing over the body, injecting all manners of deadly toxins into the blood veins at all times, and you wonder, what is the point of that procedure again? What is the point of "saving" the person again? Is it so the person can lie there, stripped of autonomy, stripped of dignity, stripped of humanity even only to lie there and passively endure, endure and endure some more?

In some of the cases, I truly felt like it was clear cut. A baby was born was spina bifida. In a normal growing baby, the neural tube normally grows to cover the brain and the spinal cord. In a baby with spina bifida, the spinal cord may be exposed, like a raw gaping hole on the spine, in the back. Surgery is possible to close the opening, but that does not guarantee the baby will henceforth be normal. In severe cases, a baby will experience mild to severe paralysis of the area of his body below the opening in his spine. Also, buildup of spinal fluid around the brain can occur and result in severe brain damage. The baby may have surgery to close the abnormal hole in his back, but can only hope to become a crawling, drooling, half person. This is no quality of life for a child. I know I sound harsh, but I think there is no need to make a person go through that if nature can choose a kinder fate for the child and let it die.

In the book, the committee ultimately opted to "make" the parents go through with the operation. The parents capitulated and now they have a child with severe mental and physical handicaps that they will have to take care of for the rest of that child's natural life. What is the sense in this? Just let the baby go already. It's better for everyone involved, why is it so hard to see that?

Anyway, if I were to have a baby one day with such a defect, I will choose to let it go. Even if I have to endure the agony of letting my own child die, I will do it for his/her sake and for my own.