Back when I was in high school I was an extremely active member of the Island Heights First Aid Squad. Summertime was no exception. I spent many days when I was not on the water on the ambulance running calls. One call just before the start of my senior year of high school is a memorable one, and I was not even on it. I think now more than ever though, it bears mentioning.
There was a rather serious traffic accident on the highway that ran next to our town. Due to a shortage of daytime crews, just like many other days, our squad was called upon to respond. The patient was a middle aged male with shortness of breath, and belly pain. Since he required extrication, the decision was made to fly him to the trauma center rather than drive him.
From what I was told then, and can better comprehend now, he was hypotensive and had a significant amount of internal bleeding. As with any other trauma patient in a similar condition, he got two large bore IV’s, and a boat load of fluid as he was transported by medivac to our regional trauma center. The area of New Jersey where I was raised was very small, and through the grapevine, word came down that after his arrival at the trauma center he had passed away.
We were told that due to the patient’s religious beliefs he refused a blood transfusion. Because of his depleted volume and the seriousness of his internal injuries, without the assistance of blood products the trauma team was unable to save him.
The reaction from some of my fellow EMT’s was one of sadness and anger. Many could not understand how this man could possibly put his religious beliefs and his expectations in the afterlife above that of the life that they had worked so hard to try and save that late August afternoon. But that is what he wanted, and the trauma center was willing to honor and respect it.
A few weeks later my squad held an in-service in which they had someone of the same religion come in and answer questions about the how’s and why’s of this man’s beliefs, and why he decided to do what he did. It helped some come to terms with what happened, and others were still confused and angry but at the end of the day, it was his wish. It was what he wanted for his life.
By now, the story about the Pennsylvania couple who chose to pray for their child to be healed rather than have them transported to the hospital has gone viral within the EMS community. This was not the first time this had happened either. Four years prior, they had lost another child the same way. The parents were serving probation in relation to the death of their first child four years prior. They have since been told by a Philadelphia judge that they “are a danger” to their children. Not only is this a high speed, head on collision between church and state, but it is also a huge ethical and moral dilemma for the medical community.
As emergency medical professionals we are trained, willing, and expected to do everything that we can for a patient. We work codes to the point of exhaustion, and will without a second thought put our lives on the line to try and save a complete stranger’s. It is hard for some responders to accept the fact that this may not be what that person wants. Sure, it might be an easier thing to swallow when someone puts a DNR in front of us and say that their loved one wants to go peacefully, but when it is a child, and the parents say “no thank you” and rely on their faith rather than modern medicine, well, that’s a tough one for almost any person to accept.
We are taught to be respectful. We are taught to be open, and listen to the complaints and concerns of our patient, and are taught that patients have the right to refuse care, but what are we supposed to do when that refusal of care by a parent could cause a child to lose their life? When it is a conscious, alert, and oriented adult the decision seems much easier but when it comes to a kid these decisions seem to get exponentially more difficult.
Personally, I don’t really know what the right answer is. While a person is entitled to their own set of beliefs that I am taught to respect, the logic that these two parents utilized to make the decision that they did goes against every bit of training I have received in all of my years in EMS. If I was put in this situation as a responder it would be extremely difficult not to act in the best interest of the child, but overcoming the protests of the family could prove to be quite the challenge. I am sure that we have not heard the last of this case, and I’ll be watching closely as more developments surface.
My first gut instinct is that if an adult of sound mind wants to make that call for themselves, they have that right. Instinctively though I have a problem with a child (or two) being condemned to death because of someone else’s decision- a decision based on nothing more than a skewed interpretation of a flawed book. The kid doesn’t get to choose, but my guess is if s/he could it wouldn’t be death.
I could write a blog on that MVA. I was the EMT holding stabilization as “both”
of us were cut out of the vehicle – covered by a blanket with firefighters
working above us to gain access. Then on the ride to the LZ he looked into my face and asked, “Am I going to die?” I remember the medic and I responded with, “We’re
doing everything we can so that you won’t.”
It’s a hard pill to swallow, and I still reflect on that call. My burning question to this day is: Was it really fair of him to put all of those people and apparatus into motion when in the end the treatment that would have saved him was refused? The answers we
received at our Squad’s in-service predictably focused only on interpretation
of scripture, not the concrete reality of the situation.
No one could predict that the accident would happen. He was an adult and had made his religious choices . . . but, he (unwittingly) had put more people than himself in peril
that day. Didn’t we (the system) have the right to treat him?
He was a viable patient who could have survived. I thank MY God that others didn’t perish in an accident involving the responders coming to his aid.