Mr. Scott is awake. He has good insight into his condition and understands his prognosis. He is expected to make a good recovery after all the surgeries, although with a distorted face, a hole in his neck for breathing, and a hole over his stomach for feeding. He is begging us to remove the breathing machine now, while his body still depends on it, so that he can pass away in peace, but we are keeping him alive because he does not have the capacity to make medical decisions.

You see, this is the United States, where patients have a right to live and physicians are obligated to preserve life for patients who do not have the capacity to make their own decisions. Mr. Scott’s suicidal thoughts indicate by definition that his mind is not functioning properly, and he therefore does not have the capacity to make medical decisions. We are keeping Mr. Scott alive until he recovers and can be removed safely from the machines to experience the precious gift of life. Or would it be more humane to follow his wish and remove him from the ventilator now?

Difficult Decisions

My moral compass’s needle can’t find true North in these cases. My training taught me that there is a correct solution to every question, even the hardest ones. But sometimes, in the United States, we physicians must aid patients and their families in carrying out solutions that we would never choose for ourselves.

Dr. Taub is an emergency physician at Ezras Choilim Health Center.