Monday, November 16, 2009

Ethics as presented on TV and the realism of such dilemma

Last night, I decided to watch a new show just to see what it was about. Due to the nature of my work, in the hospital, I prefer not to watch dramas related to hospitals, like ER, Scrubs, Grey's Anatonomy. I tuned in when I saw that it was Mandy Patinkin in a guest starring role. He was FABULOUS!! The premise of the episode entitled "the Luckiest Man" is that Mandy's character, Victor, has ALS (Lou Gehrig's disease) and after a car accident, ends up in hospital on life support. His daughter is not ready to face his death while he chooses to end his life by being an organ donor. After meeting various patients, such as the video clip he decides that he wants to give his organs to other people.

The crux of the episode is about quality of life. In the end, when we are seriously ill and lucky to have time to contemplate our lives, will we be content with what we have accomplished and will we be able to say what is a "good death". As Victor put it, "I would rather go with what dignity I have left." Ironically, it is also the annual donor reunion party that day. The daughter is taken to see the party by the doctor in charge of Victor's case. The doctor actually struggled with Victor's choice because he say it as suicide versus a "good death". After a change of heart, he has a heart to heart with the daughter who explains why she is reluctant to let her father go. The episode ends with Victor being wheeled down the hall to surgery where they will disconnect the life support and remove organs. The hall is lined with family members of recipients thanking Victor for the renewed chance of life with their loved one.

I realize that organ donation is not an easy subject nor is death. I also realize that the episode is shot from the American perspective, which is has different issues or regulations than Canadian systems.

I cried my eyes out especially at the end as it is touching to see this actually shown to the public. (And did I say that Mandy was fabulous!!) It is a reality that a lot of people are not ready to face. When is it time to go? and what constitutes a good death? Definitions will vary depending on what role you play. Luckily at my facility, the issues of quality of life, dignity are considered in such cases. We check with patients often to ensure that this is the right choice for them and not just what the medical team thinks it should be, and also to ensure that it is not just a "bad day" that they just want over. Because over is over. No regrets are possible afterward once the deed of death is done.

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