In the Name of Allah, the Most Compassionate, the Most Merciful
Today, I had a baffling experience regarding doctors removing active life support for a patient including nutrition. Before I mention some of my advice after that experience, let's review some preliminary literature regarding the topic I will be discussing insha'Allah!
Narrated Abu Musa Al-Ash'ari:
The Prophet said, "Give food to the hungry, pay a visit to the sick, and release (set free) the one in captivity (by paying his ransom)."[Bukhari Book 65, Number 286]
Food and water are the basic necessities of any human, be it the healthy or the sick in fact more so of the sick. Dr. Judith Wurtman explains it here:
And yet, nutritional concerns about the critically ill patient are extremely important, and should be a high priority. Patients undergoing acute care (and the subsequent longer recovery period) must have adequate nutrient and calorie intake to potentiate healing. The body undergoes metabolic stress when critically ill, regardless of the cause.
One way to explain this metabolic stress is that there is an increase in the breakdown of protein in muscle and other organs in the body, and the body is less able to use glucose for energy. According to Mehta and his colleagues, these changes increase the protein and calorie requirements of the patient, and as they state, “Significance of nutrition in the critical-care setting cannot be overstated. If the patient’s food intake is not adequate in total calories and protein, the clinical condition will deteriorate.“ They assert that feeding the patient should start within 24 to 48 hours, and if the patient is unable to consume food by mouth, then nutrients should be administered intravenously.
On June 26, 1997, the United States Supreme Court unanimously rejected any constitutional right of terminally ill patients to doctor-assisted suicide. NY Times wrote about that decision:
When the Supreme Court ruled on Thursday that states may continue to ban doctor-assisted suicide, it addressed the kind of death in which doctors actively help patients kill themselves. What was not considered in that decision is the fact that nowadays many, if not most, Americans die because someone -- doctors, family members or they themselves -- has decided that it is time for them to go.
What might be called managed deaths, as distinct from suicides, are now the norm in the United States, doctors say. The American Hospital Association says that about 70 percent of the deaths in hospitals happen after a decision has been made to withhold treatment. Other patients die when the medication they are taking to ease their pain depresses, then stops, their breathing.
Let's review the difference between Passive Euthanasia vs. Active Euthanasia through this BBC article. This article explains some analogies that are really helpful so do read please insha'Allah!
Active euthanasia occurs when the medical professionals, or another person, deliberately do something that causes the patient to die.
Passive euthanasia occurs when the patient dies because the medical professionals either don't do something necessary to keep the patient alive, or when they stop doing something that is keeping the patient alive.
The author further argues:
so there is no real difference between passive and active euthanasia since both have the same result: the death of the patient on humanitarian grounds
thus the act of removing life-support is just as much an act of killing as giving a lethal injection
The NY Times article titled 'Passive Euthanasia' in Hospitals Is the Norm, Doctors Say' further continues:
''That lack of candor about how the patient's death will occur and under what conditions is the thing that's particularly troubling,'' Dr. Battin added. ''The patient is being invited to make a choice without understanding what the stakes are.''
It is even worse, she said, when family members make these choices for patients. Dr. Battin said she spoke about the issue to an ethicist when she visited the Netherlands, where doctors who help patients kill themselves are typically not prosecuted.
''You Americans talk so much about the slippery slope,'' she recalled the ethicist saying, ''But we perceive you as being much farther along the slippery slope than we are.'' Dr. Battin said she agreed.
In summary, much of Europe practices Active Euthanasia. Much of America does it passively and that classifies those doing it as HYPOCRITES. Advice on how to deal with these Passive Euthanasia practitioners aka passive killers:
1) Stand your ground for your loved ones.
2) If your loved one left an advanced directive, that's great. But if they didn't, don't make decisions under stress
3) If the hospital is not allowing any machines and plans to withdraw nutrition - they consider it merciful to withdraw food and water - take the patient home.
4) Insurances don't usually stop paying that quickly. Sometimes, it's just some of the doctors who want that patient gone.
5) Do istikhara before making any big decision. Place your Tawakkul in Allah and ask Allah to make the decision for you.
6) Make Dua for your loved one and for yourself so that no one is ever left at the mercy of doctors practicing passive euthanasia.
7) Always check out facilities on their policies regarding what they consider artificial life support before taking your loved one there.
8) Be careful of illegally placed DNRs. It happens more than normal.
May we all live a healthy life and die a peaceful death without ever being starved to death. A'meen.