Clinical judgement on treatment of dying (letter)by Dr David van GendNews Weekly
, August 13, 2005
There is one key question to be asked by those looking after an injured person like Mrs Maria Korp: "Is the patient dying?"
If, in best clinical judgement, this patient is indeed dying of irreversible injuries, then we should not prolong her dying.
If, however, the patient is not dying, then doctors must not make her die. As with all tragically disabled people, we simply continue their ordinary care.
In the case of Mrs Korp and her feeding tube, the Public Advocate, Julian Gardner, affirmed that she was dying of her injuries, and that "the artificial feeding that has been provided to Mrs Korp is prolonging her dying".
On the question of why the tube feeding could not be left there while she died, he stated: "Her body is no longer able to process it. Her injuries are so horrific that they are making it impossible for her to live even with this treatment."
On that clinical judgement, Mrs Korp is indeed dying, and the feeding tube was indeed burdensome and to be removed. But it was a grave failure of Mr Gardner not to make the clinical facts clear from the start, leaving an appalling misconception that Mrs Korp is being starved to death simply because she is disabled.Dr David van Gend,
Senior Lecturer in Palliative Medicine,
Mackenzie House Medical Centre,