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Who should have the final decision on the future of a severely injured person, husband or parents?

Brett December 11, 2019 at 03:17 10200 views 58 comments

Imagine this; a woman of 40 years is severely injured in an accident, so severely that if she recovers then her life will be hell.

Her parents want her taken off life support to be allowed to die. Her husband wants her kept on life support until she recovers.

Setting aside legal positions, who should have the final decision?

Comments (58)

Deleted User December 11, 2019 at 03:35 #361717
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Brett December 11, 2019 at 03:46 #361718
Reply to tim wood

Okay; hell is a lifetime of chronic pain and disability.

The victim is unconscious but could become conscious on the basis of ongoing medical care.

Assuming someone can be killed even though they may return to consciousness.

No children. Husband or wife; I don’t see any difference.
Deleted User December 11, 2019 at 03:52 #361720
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Brett December 11, 2019 at 03:57 #361723
Reply to tim wood

If she recovers she will live with chronic pain and disability.

Being killed on the basis that euthanasia is legal.

Being a Moslem it might, so let’s say it’s not a Moslem.

The question is quite clear.
Deleted User December 11, 2019 at 04:00 #361725
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Brett December 11, 2019 at 04:02 #361726
Reply to tim wood

Who has the right regarding the victim to decide her future if it is to be between the husband or parents?
Deleted User December 11, 2019 at 04:44 #361738
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khaled December 11, 2019 at 05:12 #361744
Reply to Brett Are you asking who should as in: "In any given situation should the spouse or parents take priority" or as in: "Which do you side with the spouse or the parent"

If it's the first: idk
If it's the second: I am leaning towards the parents but it really depends on how hellish hell is

Quoting tim wood
taken it out of America


Did anyone ever say this was in America in the first place? I can't find that. Not that I think it would matter
Brett December 11, 2019 at 05:40 #361751
Reply to tim wood

I did say "imagine this", and "set aside legal issues".
Brett December 11, 2019 at 05:44 #361753
Reply to khaled

Quoting khaled
it really depends on how hellish hell is


A life you wouldn't chose for anyone.
khaled December 11, 2019 at 06:11 #361761
Reply to Brett As an antinatalist I wouldn't choose any life for anyone so this doesn't tell me much

To be honest, I think there should be an official way to deal with these situations in the first place. People should be able to write a "bearable life standard" where they specify the degree of injury overwhich they want their lifesupport to be unplugged. Just remove the whole sticky ethical dilemma by making them take the decision beforehand. And maybe introduce a yearly reminder to update the standard so people don't forget
Brett December 11, 2019 at 06:35 #361765
Reply to khaled

This is not about law but a moral decision, without the aid of a legal system to help.

khaled December 11, 2019 at 07:16 #361770
Reply to Brett So you're asking who I side with, the parents or spouse? Again, depends on how hellish hell is and what I know about the person. Though I side with the parents on this one
Brett December 11, 2019 at 07:23 #361771
Reply to khaled

Quoting khaled
Though I side with the parents on this one


Any reason why?
khaled December 11, 2019 at 07:35 #361773
Reply to Brett I think in this scenario you should try to act as you believe the patient would have acted and I think most people would want their life support cut off in that scenario (which is why I said depends on the person)
Brett December 11, 2019 at 07:38 #361774
Reply to khaled

So you feel that the parents are acting more in the interests of the victim than the husband?
Brett December 11, 2019 at 07:43 #361775

Reply to khaled
Who has this right over her future; the man who loves her or the women who gave birth to her?
Pantagruel December 11, 2019 at 15:58 #361832
Quoting Brett
Imagine this; a woman of 40 years is severely injured in an accident, so severely that if she recovers then her life will be hell.

Her parents want her taken off life support to be allowed to die. Her husband wants her kept on life support until she recovers.

Setting aside legal positions, who should have the final decision?


Could there not be different right answers depending on the specific person in question? Some people might be motivated by religious ideas, others by empathy, others by selfish reasons.

In general, how can we ever know that we are doing the right thing? Especially when it comes to the welfare of others. Should people be given what they want, or what they need? Who knows best?

In the end, the best you can do is to be brutally candid with yourself about what your own motives are, then proceed from there.
Hanover December 11, 2019 at 20:07 #361865
Reply to Brett Ideally, the victim has signed a power of attorney prior to her injury that sets out her wishes if she becomes incapacitated and sets forth who has the power to decide for her. Assuming she has opted not to affirmatively clarify, she has effectively deferred to whatever the law states. My assumption is that it would be the spouse and not the parents who would then decide because upon marriage, one is generally considered fully emancipated from their parents' control.

I know your question was a moral question and not a legal one, but I think the morality is tied to the fact that we're trying to express the wishes of the victim, and I do impute some responsibility upon the victim for their decisions prior to victimhood, which would include their decision to allow the law to decide for them in the event they didn't otherwise specify a different course.
Hanover December 11, 2019 at 20:17 #361872
Quoting tim wood
No one. In limiting it to parent and spouse, you've effectively taken it out of America, where, I believe, even the comatose are entitled to representation. There is the issue of competency. The victim first has to be ruled incompetent. If incompetent, often such people are assigned a lawyer to represent their interests. That is, even if all the family on all sides are in agreement, that's not by itself enough. I said no one; maybe I "should" amend that to the court with jurisdiction.


You're suggesting that the state appoints a lawyer to every person in a nursing home who has end of life treatment decisions to make but are incapacitated to make them? Do you have a cite for that? I'm quite sure it was entirely a family decision when we decided to stop dialysis treatment for my father when he was suffering from many other ailments, including dementia.

Regardless of the dubious factual declaration, it's irrelevant to the question of the OP, which simply asked whether the spouse or the parent was the better suited person to make such decisions, specifically indicating that they were not interested in what the law dictated, but only in what ought to be.

That is, when a person can't decide for themselves, do we defer to mom or spouse? Which stands in a better position to make such decisions?


khaled December 11, 2019 at 22:25 #361936
Reply to Brett Quoting Brett
So you feel that the parents are acting more in the interests of the victim than the husband?


Probably yeah. (Again, depends on the victim)

Quoting Brett
Who has this right over her future; the man who loves her or the women who gave birth to her?


Now you're asking the first question to which I answered: I don't know
Under normal circumstances no one would have the right over her future but I don't know about this scenario
Brett December 12, 2019 at 00:23 #361989
Reply to khaled

Quoting khaled
So you feel that the parents are acting more in the interests of the victim than the husband?
— Brett

Probably yeah. (Again, depends on the victim)

Who has this right over her future; the man who loves her or the women who gave birth to her?
— Brett

Now you're asking the first question to which I answered:


I don’t think these two questions are the same.

To the first one you answer that you feel the parents are acting more in the interests of the victim.

But the second question is about who has the right over her future, her husband or the parents? Just because the parents are acting in the interests of the victim doesn’t necessarily mean they have the right to decide over the husband. The husband may feel he can nurse her and help her recovery. Nor does he want to lose the person who means more to him than anything. He may also feel he has to commit to an unspoken agreement that they would also always care for each other.

Does the mother have the right to come between the husband and wife?

Brett December 12, 2019 at 00:30 #361992
Reply to Hanover

Quoting Hanover
My assumption is that it would be the spouse and not the parents who would then decide because upon marriage, one is generally considered fully emancipated from their parents' control.


I think in terms of law you’re probably right. And it’s interesting that as you say, assuming it’s correct, that on marriage you are fully emancipated from your parents. But a mother may not agree in her heart about that and regard her child as something that can never be taken from her, and regard her responsibility for her child as hers until the day she dies. Her concerns will still be with her daughter, not her son in law. So there is the suffering of the mother.
Brett December 12, 2019 at 00:33 #361995
Reply to Pantagruel

Quoting Pantagruel
Could there not be different right answers depending on the specific person in question? ...

In general, how can we ever know that we are doing the right thing? Especially when it comes to the welfare of others. Should people be given what they want, or what they need? Who knows best?

In the end, the best you can do is to be brutally candid with yourself about what your own motives are, then proceed from there.


Okay, so make the brutally candid decision.

khaled December 12, 2019 at 05:56 #362093
Reply to Brett by first question I meant this:

Quoting khaled
Are you asking who should as in: "In any given situation should the spouse or parents take priority" or as in: "Which do you side with the spouse or the parent"

If it's the first: idk
If it's the second: I am leaning towards the parents but it really depends on how hellish hell is


I don't think how close you are to the victim should have any effect in the extent to which you should have control over her life. That extent is 0 for everyone
Deleted User December 12, 2019 at 06:05 #362095
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Brett December 12, 2019 at 06:05 #362096
Reply to khaled

I was trying to find your reason for siding with the parents, which was that they were thinking more of the victim's circumstances than the husband. Is that right? But then you seem to have backed away with the zero conclusion. Which still leaves the victim caught between.
Brett December 12, 2019 at 06:19 #362102
Reply to tim wood

Quoting tim wood
Had it been, of the two, which has the greater right? I'd have answered that it depends. On what? On everything.


That's the question. So what is "everything"? There is no one resolving it except us.
Tzeentch December 12, 2019 at 06:21 #362103
If a fair chance exists of regaining full consciousness, and the patient has never expressed any desire for euthanasia, I don't see how it would be morally acceptable to make such a decision for them.

What is the motivation for not waiting to see if they regain consciousness and let them make the choice themselves?
Brett December 12, 2019 at 06:24 #362104
Reply to Tzeentch

Because by that point there is no way out of the pain they've been given. You have knowingly rebirthed them into a world of pain.
khaled December 12, 2019 at 06:25 #362106
Reply to Brett Quoting Brett
But then you seem to have backed away with the zero conclusion.


What does "backed away with the zero conclusion" mean?
Brett December 12, 2019 at 06:28 #362108
Reply to khaled

I thought it meant both parties have zero rights over the victim.
Brett December 12, 2019 at 06:30 #362109
Isn't this @schopenhauer1s thoughts in action, not just theory.
khaled December 12, 2019 at 06:33 #362111
Reply to Brett oh ok sorry. That's what you meant

Quoting Brett
But then you seem to have backed away with the zero conclusion. Which still leaves the victim caught between


Yes it does. I don't know what to do in the scenario you posited. I just don't
Tzeentch December 12, 2019 at 06:34 #362112
Reply to Brett What would be stopping them from ending their life (or having it ended by doctors) after they regained consciousness?

What if they wish to continue living despite the pain? Examples of people living with pain are many, so this should be considered.

Lastly, and perhaps most importantly, consider that this person has never had the chance to say farewell to their loved ones. If I had to trade a day of suffering to be given that chance, I'd do it in a heartbeat.
BC December 12, 2019 at 06:40 #362113
Quoting Brett
Because by that point there is no way out of the pain they've been given. You have knowingly rebirthed them into a world of pain.


Lots of people end up in a world of pain and are entirely competent to decide their own future. Most people actually choose to go forward, pain and all. Some opt for suicide, but most don't.

In your OP, you ask who should make the decision? Spouse trumps parents for adults.

These are very difficult issues for people to sort through once they are faced with the question of what to do. That's why, as Hanover said, one should establish what one's preferences are before one is comatose. There are preferences such as "Do Not Resuscitate", "No 'heroic' efforts to maintain life", no intubation, and so on. If you don't want to be resuscitated, intubated, or have the crash cart rushed to your bedside to get your heart going again, then you will most likely be allowed to die. But... you have to make these preferences clear to those who are close to you (and can act on your behalf), and your doctor (who might be on hand when the accident happens, but maybe not).

Have you prepared a living will? I have not -- I should definitely get it done.
Brett December 12, 2019 at 06:45 #362114
Reply to Bitter Crank

Quoting Bitter Crank
Spouse trumps parents for adults.


Are you quoting law or your own feelings?
Brett December 12, 2019 at 06:48 #362116
Reply to Tzeentch

Quoting Tzeentch
What would be stopping them from ending their life (or having it ended by doctors) after they regained consciousness?


If euthanasia was available to them it could help. If they were Catholuc it would not. (Not totally sure on that, though).

Tzeentch December 12, 2019 at 07:10 #362121
Reply to Brett If they were very religious ending their life while in a coma would not be an option either.
TheMadFool December 12, 2019 at 07:19 #362124
Quoting Brett
Imagine this; a woman of 40 years is severely injured in an accident, so severely that if she recovers then her life will be hell.

Her parents want her taken off life support to be allowed to die. Her husband wants her kept on life support until she recovers.

Setting aside legal positions, who should have the final decision?


A situation that's a reminder for us all that we need to make our choice under such circumstances known beforehand to save your loved ones, if you have any, the agony of making life-and-death decisions for you. It's unfair on anyone's part to put others in moral dilemmas like this when a one page note expressing your decision can be written in five minutes and given legal force much much earlier than it'll ever be required.

That said I think the scenario doesn't do justice to the actual issue at stake in euthanasia which is a dilemma between living with severe pain or murder (disconnect life support). Perhaps the husband represents the intuition that removing life support amounts to murder and the parents stand for our belief that death is better than a life of pain.

Your scenario pits the husband against the parents as if one of them has greater say in the decision. That this is false is betrayed by your inclusion of the condition "her life will be hell" and "until she recovers". These conditions of her future state are the true determinants of what the choice should be and the relations of being wife or child have absolutely no bearing on the decision except in the capacity of an executor. The decision depends on one and only one factor - the quality of her existence in terms of how much suffering will be a part of it.
Brett December 12, 2019 at 07:41 #362127
Reply to TheMadFool

In some ways I may be making this as difficult as possible so that we have to dig deeper. Yes there is only one factor to consider, the quality of her existence. Which is unknown and cannot be taken back once committed to.

I understand that there are people who overcome the pain and live a life as best they can. I don’t know how many find it intolerable or end up taking their life.

Just to dig a little deeper. A mother’s love for her child is unconditional, not always but generally. A husband’s love for his wife is not nearly so unconditional. It’s conditional on a number of things, one being that she love him back. Would he still love her the same way if she said she did not love him and loved another and was going to live with that man?

Can the mother of the victim be sure the husband will commit himself to his wife whatever the circumstances or how long they went on for? Would he be prepared to put himself second the way mothers do with their children? Dos he understand the sort of commitment made by mothers, which is what would be required from him? I don’t know what it’s like to give birth to a child and watch it grow. That’s something that perhaps is impossible to be explained to me. So the depth of feeling for a mother about the suffering of her child may be something that is beyond the law.

BC December 12, 2019 at 09:18 #362143
Reply to Brett I think that's the law in many states, applying to married adults, or adults who have designated a person to have power of attorney for them.

As for spouse vs parent, I don't have any feelings about it one way or the other -- just that it needs to be clear who has the power to decide, in the event of incompetence, medical emergency, coma, etc.
TheMadFool December 12, 2019 at 10:09 #362149
Quoting Brett
In some ways I may be making this as difficult as possible so that we have to dig deeper. Yes there is only one factor to consider, the quality of her existence. Which is unknown and cannot be taken back once committed to.

I understand that there are people who overcome the pain and live a life as best they can. I don’t know how many find it intolerable or end up taking their life.

Just to dig a little deeper. A mother’s love for her child is unconditional, not always but generally. A husband’s love for his wife is not nearly so unconditional. It’s conditional on a number of things, one being that she love him back. Would he still love her the same way if she said she did not love him and loved another and was going to live with that man?

Can the mother of the victim be sure the husband will commit himself to his wife whatever the circumstances or how long they went on for? Would he be prepared to put himself second the way mothers do with their children? Dos he understand the sort of commitment made by mothers, which is what would be required from him? I don’t know what it’s like to give birth to a child and watch it grow. That’s something that perhaps is impossible to be explained to me. So the depth of feeling for a mother about the suffering of her child may be something that is beyond the law.


Oh! Thanks for the clarification. This isn't about euthanasia as I supposed. All I know is love is invariably associated with what maybe called high expecations and, paradoxically, with poor performance. When you love someone, you have high expectations from yourself but, at some point, you realize that the world exerts a certain amount of stress on everyone and it doesn't take long for the last straw to gently float down and break the camel's back i.e. people usually have a poor performance record in love. True love would and does recognize the limits of how much a person can give/take in the real world and true love exists within those limits.
Hanover December 12, 2019 at 13:53 #362179
Quoting tim wood
Are you saying you-all got to kill your father all by yourselves? No legal form observed or judgment made, no prior determination of right?


The cause of death was kidney failure, despite your attempt to mischaracterize it as a killing. In any event, you've now taken a different approach, which is to condemn the cessation of medical treatment in all instances as some form of murder. That would be the case from a moral perspective (assuming we adhere to your definition of what constitutes a killing) regardless of whether it was the result of the deliberations of the family or of some judge or whoever it might be that society has designated as the decision maker. That is to say, the relevance of who decides seems as aside if you're taking the approach that the decision itself is per se unjustifiable.

But, as to your question, yes. It was a family decision. That's how it works. I don't really know what you envision actually happens day to day, as if the courts are clogged with thousands of petitioners asking judges to decide the day to day course of medical treatment for the terminally ill. The decision the family made was simply whether to lead a terribly dying man who had no understanding of what was going on back to the dialysis clinic and whether to continue carting him back and forth several times a week. That did not require court involvement. Maybe you think it should, but I don't see from a moral perspective why that ought to be.

Quoting tim wood
As to the question, it wasn't who was better suited, it was, "who should have the final decision?" Had it been, of the two, which has the greater right?


That was the question I gleaned from the OP.







Pantagruel December 12, 2019 at 14:04 #362182
It's never too soon to put a DNR order in place....
Deleted User December 12, 2019 at 15:05 #362198
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Brett December 13, 2019 at 04:22 #362473
Reply to tim wood

This is the question now; is the love of the mother greater than the husband?
Deleted User December 13, 2019 at 04:50 #362486
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Brett December 13, 2019 at 05:32 #362501
Reply to tim wood

I'm asking if one is greater than the other.
Deleted User December 13, 2019 at 05:34 #362503
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Deleted User December 13, 2019 at 05:37 #362505
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Brett December 13, 2019 at 07:44 #362563
Reply to tim wood

Yes, we could say say it depends on the individual. We could compare the love of one husband for his wife to another husbands love for his wife, and we could compare the love of one mother for her child to another mother and her love for her child. But the comparison of the love of a mother compared to the love of a husband is not so easy. So to say it depends on the individual is of no help whatsoever.

Those who are pro abortion insist that a woman can do what she wants with her body, so when does a child no longer belong to her? It’s this aspect I’m alluding to when I compare the love of the mother and husband.

I’m assuming your male, so I don’t know how you can be sure of yourself here. But set me right if you believe you can?
Brett December 13, 2019 at 07:54 #362567
Reply to tim wood

Quoting Hanover
But, as to your question, yes. It was a family decision. That's how it works.


Quoting tim wood
And no it isn't. It's just not that simple


No, not that simple, but that’s how it happens. You seem to be very dependent on some outside authority to make a moral decision for you, but you don’t say who.
Brett December 13, 2019 at 08:15 #362573
Reply to khaled

Quoting khaled
I don't know what to do in the scenario you posited. I just don't


And yet a decision is required.
khaled December 13, 2019 at 08:18 #362574
Reply to Brett I told you my decision already: it depends on the patient but I lean towards pulling the plug. What I don't know the answer to is which of two strangers close to a third stranger should have control over the third stranger's future. I cannot conceive of a situation where I would have to make that decision
Brett December 13, 2019 at 08:20 #362575
Reply to khaled

I wasn’t meaning to harass you, just agreeing with the difficulty.
Deleted User December 13, 2019 at 15:30 #362644
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Brett December 13, 2019 at 23:52 #362854
Reply to tim wood

Quoting tim wood
Why not, then, ask the question that's really on your mind?


Which is what?