News

Ethics Discussed by Beebe Physicians and Staff

02/08/06

A terminally ill patient had asked not to be resuscitated, but then anxiously motioned to the emergency room doctor to put the breathing tube back in as she struggled in pain for her last breath, knowing she would never be weaned from the ventilator. The physician did insert the breathing tube, and family members said they did not want the patient to be given any narcotic painkillers that might hasten her death.

A terminally ill infant was rushed to the emergency room by her parents to be resuscitated, day after day. Those who saved her, again and again, watched her writhe in pain, knowing the heroic efforts were futile, that she'd never recuperate and that her death was imminent.

These were two true-life cases Marie E. Thompson, a Maryland-based professional speaker on bioethics, shared with Beebe Medical Center physicians and staff during a recent lecture and discussion.

Thompson spoke about the ethical dilemmas regarding life and death that are faced by those in the medical field, and how families, physicians and caregivers have to come together to reach the difficult answers.

What is the best thing we can do for the patient? Thompson asked. And how do we get people to come together?

Bioethics -- the discipline of dealing ethically with life and death decisions in medicine, as well as in research and science, has grown with the advance of technology. Today, most hospitals have ethic committees and patient rights' advocates to make sure that decisions are made in an ethical manner with the patient's rights and interests in mind.

We originally wanted Marie Thompson to speak to our Ethics Committee members, said Ellen Tolbert, Director of Patient Relations at Beebe Medical Center. But once I heard her speak, I felt that her message was something that all our staff might want to hear.

Marie Thompson is from Washington County Hospital, Hagerstown, MD. She serves on the Governor's Council of Healthcare Ethics and has a Masters of Arts Degree in Bioethics from the University of Virginia. She speaks regionally and nationally on end-of-life issues, advance directives and ethical principles and theory.


More than 50 physicians and staff members attended the lunchtime seminar held at the hospital. Their response was positive, with comments following the presentation such as relevant, top notch, and very informative.

In the United States, it is important to uphold the rights of the patients, Thompson said. We want to do what is ethically right. The dilemma occurs when there are two different groups that believe something is right, and they struggle with each other.

Thompson traced the history of bioethics, pointing out that patient rights became an issue in the 60s with the human rights movement. The importance of informed consent emerged after a series of bad medical research projects in which experimental treatments were carried out on unsuspecting patients. Then, in 1962, the first heart transplant was performed, which created a demand for organs. The search for organs made the definition of death more critical than it had been before.

Commissions were formed to define death and create ethical guidelines. Thompson went on to cite a series of legal battles through the 1980s and 1990s that dealt with patients in a vegetative state, and who was to decide whether those patients should be kept on life-sustaining machines. The courts have been clear that they don't want these kinds of cases, she said.

Yet, after watching all legal battles between families and politicians in the Terry Schiavo case, Thompson sadly noted, Forty years later and it seems that we haven't come anywhere at all.

Thompson reminded the attendees of the importance of written advance directives, and that when someone is diagnosed with a terminal illness, the discussion about the care to be given in the later stages of the disease should be had by the family and the physicians early in the diagnosis.

Following the presentation, Tolbert said that for her there was one clear message. Put it in writing, she said. Let your family know what you want.

*** There is a story on end-of-life issues in Beebe Medical Center's Beacon magazine published this month. It includes information on advance directives and also has a list of additional resources free to the public.