Ethics: Terminal Care for an Elderly Cancer Patient?

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What would you do Wednesday!

Eighteen months ago, a seventy-one-year-old Christian woman developed cancer in a kidney.  Physicians removed the kidney.  Now, however, the cancer has spread to other parts of her body, including her brain, so she has become permanently unconscious.  Her second kidney is now failing, and she needs dialysis.  Dialysis might keep her alive for six to nine months.  Without dialysis, she would probably survive a couple of weeks before drifting off into a relatively painless death caused by the buildup of toxins in her body.  An experimental drug that might have some effect on her cancer is just coming onto the market.  If she could survive for six months, this new drug might help her fight the cancer.  Despite her insurance policy, all this treatment will surely deplete the woman’s considerable life savings.  Only then would government programs pick up what insurance will not pay.

She never told her children how she felt about the terminal care.  Her son thinks death is inevitable and wants to avoid dialysis.  He thinks bankrupting the family for a long shot is pointless.  Her daughter, a Christian with a pro-life perspective, feels uneasy about not doing everything she can to help her mother.  You are a trusted friend of the daughter… Your friend comes to you for guidance.  What should you say?
[Source:   David Clark and Robert V. Rakestraw, Readings in Christian Ethics: Issues and Applications. vol. 2.  Grand Rapids: Baker Books, 1996, p. 132.]

  • How would you advise this family?
  • If it were your family would your advice be different?
  • Is this woman’s life worth less because she is unconscious?

What do you say?

Let's connect!

tagged as , in Culture,morality

{ 2 comments… read them below or add one }

1 Bob Palermo October 6, 2010 at 11:59 am

This is always a difficult decision simply because we don’t know what results these drugs are going to produce. My wife has a rare form of pancreatic cancer where treatments have had mixed results. Thankfully, she has had a relatively good quality of life since the diagnosis 4 and half years ago. So I speak from experience with her treatments.

The life of anybody is always precious in my mind. Unless the patient directs otherwise, we should pursue treatment no matter what. Worry about finances is simply a lack of trust in God and may be considered valuing wealth more than human life. But that said, we still must be wise about how we pursue treatment. When cancer is at the advanced stages, there may be nothing that can be done so trying out a treatment or the newest and latest drug would be unwise. Certainly, counseling with a Christian doctor on what care is appropriate is the first step. He would be the best source of advice on how far the disease has advanced. While dialysis might help, and may be worth trying, her condition would need to be monitored for other life threatening issues while on dialysis. Based on what the secondary condition is, available treatment and the associated life expectancy, the decision to continue dialysis or not would be made.

Assuming there aren’t any other issues, try the drug to see if it reverses the progression of the disease. In 3 months, a comparison of CT scans before and after will reveal the effectiveness of the drug. If it doesn’t do anything, then the family will know that everything that could have been done, has been done.

This is how I will pursue treatment for my wife and how I would recommend others to the same for their family members. I know that the above discussion is brief as there is much more to be said about this issue. Hopefully, the reader will understand what’s written knowing that some details have been omitted.

2 Mark October 7, 2010 at 9:50 am

Bob,

Thanks so much for your response. I’m sorry to hear about your wife’s pancreatic cancer, but I am glad to hear about her quality of life. These decisions are difficult and multifaceted. There is no easy answer. This especially stood out to me when you stated:

The life of anybody is always precious in my mind. Unless the patient directs otherwise, we should pursue treatment no matter what. Worry about finances is simply a lack of trust in God and may be considered valuing wealth more than human life.

Of course, it is also very difficult if you’re the one suffering. My wife does not have cancer, but suffers from a back injury (her prayer here). Again, I appreciate your thoughtful and insightful comment.

.

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