The other side of technology
A day too late for the last entry, the Johns Hopkins Magazine arrived containing an interview with Ruth Levy Guyer RE her new book, “Baby at Risk: The Uncertain Legacies of Medical Miracles for Babies, Families, and Society.” Basic theme of the book is that everything in the NICU isn’t wonderful. A triumph of technology over reason. “The doctors salvaged my son, they didn’t save him. My heart is broken every day.”
To paraphrase our last entry, we have been so successful at “saving” ever more premature babies that we have failed to add value to their lives or the lives of their families.
JHM tries to paint this as a right to die issue, but Guyer talks about compassion. “That is not a life that most adults would want for themselves. Why are we asking babies to endure that?”
Not addressed in the JHM article (and I haven’t read the book) is the added cost of lifelong healthcare needs for many NICU graduates. As prematurity increases, the probability of seizures, cerebral palsy, blindness, etc. increases. Haven’t seen anyone put dollar figures on that calendar, but it shouldn’t be too tough. The hard part is deciding where to draw the line. Sometimes you get a tiger by the tail and wish you’d kept your hands in your pocket.
We have the technical ability to preserve life by heroic means, but we lack the wisdom to know when to use that ability--or more precisely, when not to. It’s the technological imperative--I can, ergo I will. NICUs come with ethical blinders, and this is another technology factor that drives up the cost of healthcare.
To paraphrase our last entry, we have been so successful at “saving” ever more premature babies that we have failed to add value to their lives or the lives of their families.
JHM tries to paint this as a right to die issue, but Guyer talks about compassion. “That is not a life that most adults would want for themselves. Why are we asking babies to endure that?”
Not addressed in the JHM article (and I haven’t read the book) is the added cost of lifelong healthcare needs for many NICU graduates. As prematurity increases, the probability of seizures, cerebral palsy, blindness, etc. increases. Haven’t seen anyone put dollar figures on that calendar, but it shouldn’t be too tough. The hard part is deciding where to draw the line. Sometimes you get a tiger by the tail and wish you’d kept your hands in your pocket.
We have the technical ability to preserve life by heroic means, but we lack the wisdom to know when to use that ability--or more precisely, when not to. It’s the technological imperative--I can, ergo I will. NICUs come with ethical blinders, and this is another technology factor that drives up the cost of healthcare.
Comments
Many years ago, when I was working in a military hospital ICU, we had a patient with on-going end of life problems. To "contain" this problem, they first amputated both his arms at the shoulder. Then they had to amputate both his legs at the hip. Then they were going to take out most of his intestine but the nurses began to revolt on the extreme measures being taken for this patient who, becuase he was unconscious and had no family, could not say "enough". The surgeries did stop and the patient was allowed to die. However, it really raised the awareness of the delema between our striving for the length of life over the quality of life. Whose interest are we serving when we go to such extremes just because we can?
Posted by: John Harrison, RN, MHSA | February 11, 2008 12:23 PM