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Monday, March 24, 2014

Tim Bowers and Lethal Language

This Friday I am giving a talk about the death of Tim Bowers. Bowers died within 24 hours of a devastating cervical spinal cord injury. Bowers death was highly unusual and controversial. The day after his injury at the family's request Bowers was taken out of heavy sedation and told of his condition. In emotionally laden language Bowers was told he would be a vent dependent quad. Bowers pregnant wife told him he would never be able to hold their child. In all likelihood Bowers would live in a nursing home totally dependent on others. Given this prognosis, Bowers chose to die and the vent that kept him alive was removed. He died shortly afterwards. 

Bioethicists such as Art Caplan, praised the family and physicians involved. A prefect case of a patient asserting his autonomy. I read this statement and shake my head in wonder. What if Bowers had been severely burned? Would he have been given the same "choice"? I think not. What disturbs me is the unquestioned assumption that life as a vent dependent quad lacks any value. When I think of Bowers I am taken back in time to the first year I was paralyzed. There were no high level quads. One night I asked why were there no upper level quads. I was told to think about it. Puzzled I could not come up with a logical answer. Think about it I was told. Would you want to live as a C-3 quad instead of being a T-3 para. Of course not. Nature I was told was allowed to take its course. The logic apparently was any injury above C-8 was not worth living. At C-8 the thinking was one could still transfer independently with a sliding board. Any injury above C-8 created a life of physical dependence that was not worth living. Not much has changed in 30 years. A C-8 SCI has been replaced by being vent dependent. The lethal logic circa 1978 has not changed. Being paralyzed leads to diminished quality of life. Expectations, typical life experiences, are believed to be impossible to obtain or achieve. This belief is deeply ingrained in the American psyche. Lethal thoughts can and do lead to lethal actions. 

If readers happen to be in the Syracuse are information about my talk is below. 

Consortium for Culture and Medicine Seminar 
 Friday, March 28, 2014 
4 to 5 pm 
Room 1507/1508 Setnor Academic Building 
766 Irving Ave 
“Does Lethal Language lead to Lethal Treatment? End-of-Life Issues”

William J. Peace, PhD
Renee Crown Honors Program, Syracuse University 
We will discuss the decision-making strategies that take place
immediately after devastating injuries, focusing in particular on
decisions to remove patients from life-sustaining treatment. Of
particular interest are patient autonomy, the notion of dignity,
terminal sedation, and VSED (voluntary suspension of eating and
drinking).  The story of Timothy Bowers, the hunter who was taken off
life-sustaining treatment twenty-four hours after experiencing a
devastating spinal cord injury, will serve as a test case. 
Free and open to the public 


Matthew Smith said...

That is beyond disgusting. In this country they would most likely have been charged with encouraging a suicide and any nurse or doctor who witnessed it and didn't intervene subjected to disciplinary action. I hope someone can get the doctors responsible for this struck off.

william Peace said...

Matthew, Bower's death has been hailed by bioethicists as a perfect case of patient autonomy. Evidence that bioethics as a field has made progress and empowered patients to assert their free will. Comments following the many news stories that appeared at the time of Bowers death hail him as a selfless hero. Those shocked and dismayed by Bowers death are a small minority--mostly people in disability rights and some in rehabilitation medicine.

Extranjera said...

Arthur Caplan's making 'bioethicist' a dirty word. Is it just me or does it seem reasonable that I keep thinking that he must have a deep-seated hatred or some darker agenda when it comes to disability? I can't help but think that there's actual malice there.

william Peace said...

Extranjera, Theere is a fundamental disconnect between bioethicists and mainstream American culture. Art Caplan was just honored today by the National Science Board as the 2014 recipient of the the Public Service Award for an individual. Some of his scholarship is top notch. My main critique is he considers himself to be America's bioethicist. It would be nice if the news media asked another bioethicist a question once in a while.