What price do you put on someone you love? That’s the real and unasked question in the debate on passive euthanasia – terminating the lives of the incurably ill who are no longer conscious or capable of acting on their own. I recall a family’s terrible dilemma which i found myself involved in some years ago.
One of the sisters in the family was stricken by an irreversible and fatal disease that attacks the auto-immune system and for which there is no known cure. The diagnosis had been made too late to try alternative therapies which might have deferred the inevitable. The patient – to whom i was not related but who was as close to me as if she were my own sister – went into a coma and was taken to a state-of-the-art medical facility in Delhi.
The moment she was admitted into the hospital, the patient, in effect, ceased to be a human individual with human attachments of family and loved ones and became instead the property of a team of medical specialists. No longer conscious of where she was or what was happening to her, she was put into an intensive care unit which no one could enter except those who were treating her. We could see her through a glass pane, attached to mechanical devices which took over from her the business of existence: the breathing of the lungs, the beating of the heart, the circulation of blood, the intake of nutrition. She became a machine, linked to other machines.
Regular as clockwork the attendant team of specialists would look in on the patient. Literally look in. Open the door, look at her from the doorway, make a note on clipboards they were carrying and go away. It was a large team and day by day it seemed to get larger. Who are all these people? i asked a nurse. Doctors, she replied.
What sort of doctors? i asked. Special doctors, said the nurse. They were indeed special doctors, as i discovered. One was a dietitian. Another was a dermatologist. Why did a patient unable to take in any nutrition other than through a drip need a dietitian to visit three times a day? No one knew. Why did the patient need a dermatologist’s visit every day? No one knew.
But each time these specialists would look in on her, the visit would be put on the bill. Which, like the team of specialists, was daily growing bigger. It was, after all, a state-of-the-art private hospital. With high overheads, including specialists who occupied expensive offices and had to earn fees in order to pay their rentals.
Twice a day we’d go to see the head doctor. No, there was no change in the patient. No, no change could be expected. No one could bring themselves to ask the question that hung in the silence like a thunderclap: How long do we go on like this, how long can we go on?
The family was reasonably well off. But how long could they afford to keep the patient in the hospital? One month? Two? A year? There were other expenses to meet, a son to be educated, futures to be provided for. But how do you put a cut-off price on a life? Even on the life of a machine kept alive by other machines.
The family couldn’t do it. So i volunteered. I told the head doctor there was no more money for the ICU, for the machines. The doctor looked thoughtful. I see, he said. There was no talk of the law, or of ethics. No talk of the sanctity of life. No talk of miracle cures.
Sometime that day, we weren’t told when, the machines were switched off. The patient stopped being a patient and became a closed file and a final bill. Which the family paid, racked with remorse, feeling that what they were paying was blood money. Was this sum what a life was worth, no more and no less? To the loss of a loved one was added the burden of guilt.
Parliament (in India) can legislate on the ethics of euthanasia. Who’s going to legislate on the economics of death, and the cost that conscience has to bear? What is the price of someone you love?
P.S. In Nov. ‘10 my mother was in ICU in Chennai for the last 10 days of her life where she died due to complications from breast cancer. This article describes the exact state of events that happened to me and my family. I couldn’t have described it better.