A Death Panel of One 10 comments

By Andy Whitman

His eyes were open, and swimming in his head. But there was nobody home, or so they told me. All the tests showed it to be so. My father had suffered a heart attack, and had stopped breathing for several minutes.

By the time the ambulance arrived he was brain dead, although the medics were able to restart his heart. And so now he lay prostrate in a hospital bed, improbably alive against all odds, a ventilator pumping air into his lungs, and with eyes open and dancing in his head. But there was nobody home.

I think about that scene, which occurred a little more than two years ago, with increasing frequency these days. The specter of “death panels”—shadowy, government-appointed bureaucrats with the power of life and death in their calculators and actuary tables—has risen again.

It first came to light in 2009, a year after my dad died, when several politicians pointed out that a new health care reform bill included a provision to pay doctors to consult with their patients about “end of life” care.

Euthanasia was right around the corner, or so claimed the bill’s critics. Not so, said the bill’s supporters. Shouldn’t patients be allowed to make rational decisions about the extraordinary measures used to keep them alive? And shouldn’t doctors be paid for their consultations?

Now the proposed legislation has become a reality, and the debate rages once more. It’s all about economics, and why some people can’t afford to live. No, it’s all about sharing information, and offering dignity and informed choices to those who won’t be able to make decisions for themselves when they’re lying in a coma.

As best I can tell, they may all be correct.

As my father’s oldest child, and the only sibling available to make a decision, I got to serve as a death panel of one. My father had never indicated his “end of life” wishes, but there he was, his heart thumping away, his brain flatlining, with no end to the hopelessness in sight.

“We can keep him alive indefinitely,” a doctor told me. “We can keep his heart beating. We can help him breathe with the help of a machine. We can feed him by a tube. But there’s nobody home. What would you like to do?”

What would I like to do? Was that a serious question? What I would have liked to do was run shrieking down a hospital hallway. I would have preferred to pretend that none of it was happening. But it was, and I could not.

Somebody—in this case, me—needed to make a decision. In the merciless march of progress, we had now arrived at the sharp point of the thorny conundrum: when does life end?

Christians rightly recoil at the concept of “quality of life.” And I understand. Who are you, O man, to decide such things? Who are you to play God? Human beings have intrinsic worth precisely because they are made in the image of God, and not because of any utilitarian “productivity” they may bring to the proceedings.

And yet, and yet....

My father lived on because a well-trained medic had played God and restarted his heart. He lived on because a machine was pumping air into his lungs via a tube down his throat. His body lived, but his brain did not.

And where was the soul in all of this?

In the end, I pulled the plug. Not literally, of course, but I gave the bureaucratic order. I would like to think that it was the most merciful thing I could have done. And yet I still pray for God’s mercy on that decision. There is no righteousness in a son giving the order to stop his father’s beating heart, although I believe that what I did was right and proper.

The ventilator that helped my father breathe was removed. And impossibly he kept breathing. He breathed, on his own, for another week. He would not die. Eventually, the official cause of death was heart attack, but the real cause might have been starvation. An old person can survive for six or seven days without food and water, but not much more than that, and my father proved to be an exemplary old person.

Now, with the debate raging around me again, with every histrionic, strutting politician loudly weighing in with an opinion, I recall scenes that I would rather not recall.

The nurses in the hospice unit eventually taped my father’s eyes shut. The dancing eyes were purely muscle reflex, they assured me. Nevertheless, they were spooky. I think about them every time I read another sanctimonious editorial about encroaching euthanasia.

“You have no idea,” I want to respond. “There is life that mimics life, but is not life. It is nothing at all.” I suspect I want to respond this way so I can feel better about myself, to justify my decision, to assuage the nagging feeling that, in spite of all medical evidence, I live with doubts and fears.

Because there are days when it is still not easy to look in the mirror.

When I do, I see someone who looks startlingly familiar. I have his round face, his receding hairline, his ruddy complexion that may be an early indicator of heart problems down the line. And I have his eyes.