16th July 2010
Paralysed accident victim blinks to signal decision to remain alive
Last October, Richard Rudd, who is 43 years of age and has two teenage daughters, was severely hurt in a motorbike crash. He was kept breathing by a ventilator. He seemed completely paralysed and non-responsive. His family remembered him saying he wouldn’t want to live in such a state and gave permission for the medical team to switch off the ventilator.
He was in Britain’s leading brain care unit at Addenbrook’s Hospital in Cambridge, under the care of Prof. David Menon. Prof. Menon held open Richard’s eyelids and asked him could he move his eyes, and when he did, a lifeline of communication for Richard was opened. Using eyes right for yes and left for no the language therapist was able to establish that he was able to understand and remember, and eventually he was able to signal clearly that he did not want the ventilator to be switched off.
The discussions and feelings of the family and medical team were the subject of a BBC documentary Between Life and Death and it is a ‘must see’ for anyone concerned about the decisions such cases raise.
Prof. Menon explains that Richard is not ‘brain dead’ but has a form of paralysis termed ‘locked-in syndrome’, the condition that is described so well in the book The Diving Bell and the Butterfly by Elle editor, Jean-Dominique Bauby, who suffered a similar paralysis, later made into a a film with the same name in 2007, which follows the marginal recovery that enabled him to dictate the book.
The BBC documentary raises all kinds of disturbing questions. In the background is the troubling issue of money. Long term care is very expensive so as a society we need to be clear and strong in resisting any ideology providing rationalisations for the deliberate taking of human life. A disturbing issue in the documentary is the suggestion that the medical team is not asking for the families permission to switch off the ventilator, that they, the medical experts will decide what the appropriate treatment is, and that the family is only giving them information about what the patient’s wishes might have been. This implies that basic care, like feeding and assistance to breath is a treatment.
More to the fore in the documentary are the arguments for deliberately ending the lives of helpless people because they have no quality of life. Early in the documentary, his father says Richard has no quality of life, he is making no responses, that he’d said he wouldn’t want to life like that. But in time he is able to move his eyes and his father accepts that he is now able to smile. And he chose not to have the ventilator switched off. Towards the end of the documentary, his father reconsiders his earlier view. It’s all hypothetical, he said, imagining how you think you’d feel if you were in a similar situation. But now he has seen his son’s eyes light up when they are conversing together, and he smiles. When you find yourself in that situation, his father said, the will to live kicks in. And about the decision to switch off the ventilator when his is not brain dead after all, ‘you probably have no right to do that.’
If society is not willing to put the resources into respecting life in its most vulnerable moments, then how will the breakthrough advances and discoveries ever be made – Richard was completely unresponsive at first for months, but then he began to respond, and as the film The Diving Bell and the Butterfly shows, people working with patients in this condition invent ways to enhance the communication. Respect for life at risk is where the developments happen.
Watch eight minutes of the BBC documentary which includes Richard’s father responding to his son’s wish not to be taken off the ventilator here