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Starting Out: Medical advances inevitably create ethical dilemmas

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It is three decades since Miss M, then 17, had her life brought to a standstill in a road accident. Today, she still lies motionless at the end of a hospital ward – her neck permanently twisted through a crazy angle, her mouth agape and her eyes turned up toward the ceiling.

It is three decades since Miss M, then 17, had her life brought to a standstill in a road accident. Today, she still lies motionless at the end of a hospital ward – her neck permanently twisted through a crazy angle, her mouth agape and her eyes turned up toward the ceiling.

Dedicated nursing care manages to keep her poor body ticking over but it seems to sustain a mechanical existence rather than a real life. Her brain damage appears to be irreversible and genuine hope of communication with her has long been abandoned.
For me as a nursing student, helping with Miss M has deepened my awareness of the tragedy that nurses have to face.

Unexpectedly, it has also forced me to consider the dark ethical implications that can underlie treatment.

At the heart of it all is a terrible irony. For previous generations, the difficulty would not have arisen. Miss M would not have been kept alive because the available surgico-medical skills would not have been up to the task.

Now, medicine has increased its scope and, in an act of benevolence, has used new knowledge to fix her in a kind of limbo, neither living meaningfully nor being permitted to slip away into an arguably merciful death.

Have we any right to do this? Should we fend off death, no matter what?

Some seasoned nurses say they have long since ceased to worry about these things. They advise me to get on with the job and just keep doing my very best.

I like this sort of pragmatism, not least because it keeps us sane.

Yet Miss M’s predicament is going to be replicated more and more in the future and, as an aspiring nurse, I want to know exactly what I am committing myself to. If that means a lot of uncomfortable thoughts, so be it.

Lesley McHarg is
second-year student at Paisley University

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