Grey Areas and Life-Altering Decisions

As another article on here referenced, end of life decisions are extremely difficult, especially for families.  But is it even more difficult when the family is not the one making the decision? This article from the New York Times explains the journey that the family of Ms.Nyirahabiyambere has went through with the end of life decisions surrounding their mother’s feeding tube removal.  It sounds odd that the family of Ms.Nyirahabiyambere isn’t the one making the decision about the removal of her feeding tube, but a court appointed guardian.  We often talk about the lower health status of immigrants, but I was always under the impression that this lack of health services usually applied only to illegal immigrants.

Ms.Nyirahabiyambere is legal immigrant from Rwanda.  Her family was in a refuge camp when her two eldest sons were placed in the United States.  Six degrees later they were able to bring their mother over to join them in the states.  Ms.Nyirahabiyambere suffered a massive stroke that left her in a vegetative state.  Usually, this sort of thing is covered by Medicaid as Ms.Nyirahabiyambere did not have private health insurance.  However, being in the country for less than five years she is not eligible for Medicaid, and the cost to keep her alive for her family is just too high.

Since it is the government and Georgetown University Hospital footing the bill, they are the ones making the decision.  This leaves me at a crossroads in my thinking as to if this sort of decision making is ethical and just.  Can a set of humans who have nothing invested in the cause make a life-altering decision simply because they are supplying the funds?  The article shares that the family does wish to keep their mother alive if funding would allow.  I do not agree that it should simply be the people who are losing money that are making the decision as it is obvious that they would agree to protect their investment.   It seems that the story of Ms.Nyirahabiyambere is one of those that simply falls in a grey area and leaves her at a loss.  I don’t know of another way that this type of conflict could be solved, but I’d be interested to see your opinion on the matter.


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One response to “Grey Areas and Life-Altering Decisions

  1. mpowers

    I think this is a really tricky subject in which there are a lot of things to consider. First, if a patient is in a vegetative state, does that make them dead? Does it make them dead “enough” to be taken off life support? Oftentimes the family of the patient will not want to remove the support even if the patient will never wake up. We, as humans, never want to let go of our loved ones. You asked if it was just that the family could not decide because they were not supplying the money. But here is another question. Is it fair to take up a bed and resources in a hospital that could go to a person who is not in a vegetative state–someone who can be cured and then sent on his way? These were just some of the questions I thought of. I think we often focus on the negatives of one case, but we sometimes forget that there are other circumstances surrounding that case.

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