Should I remove the oxygen tube or not?

This is the 4992nd article of Da Yi Xiao Hu

There is a plot in the TV series "The Way of Heaven" where Ding Yuanying's father was admitted to the ICU because of cerebral hemorrhage. At first, Ding Yuanying told the doctor that he would actively treat him, no matter how much money it cost. But after a period of treatment, the doctor told Ding Yuanying that his father was seriously ill and was relying on a ventilator to maintain his life, and it was impossible for him to wake up. In this case, Ding Yuanying made a difficult decision to give up rescue. He asked to remove the ventilator tube so that his father could die with dignity. His decision was also strongly opposed by his mother and brother at home, who accused him of being unfilial.

The situation of Ding Yuanying's father is not uncommon in clinical practice. Some patients who have been in a coma for a long time have relied on medical measures to maintain their lives for several years, which has caused a huge economic burden on their families and society. In fact, in the author's daily communication with people around him, most people are relatively open-minded about such issues, saying that if they become sick and cannot take care of themselves in the future and need to rely on medical equipment to maintain their lives, they are unwilling to prolong their lives in this way. However, when facing their own relatives, the choice becomes very difficult. Some family members said that they would treat the patient at all costs, even if the patient is a vegetative state; while others would consider the doctor's advice and give up treatment when the patient has no hope of recovery.

In traditional Chinese culture, family values ​​and filial piety are important, emphasizing that family members should support and care for each other. Filial piety requires children to respect, support and accompany their parents. In this cultural context, Ding Yuanying's decision to give up treating his father is undoubtedly a challenge to traditional family values ​​and filial piety.

Western society may have a relatively open and diverse attitude towards similar issues. On the one hand, Western society generally respects the right of individuals to choose, including decisions when facing life and death. Many people will even sign a document when they are still healthy, indicating that they will give up rescue measures at the last moment of their lives. The patient's wishes will be respected by the hospital and their families. Secondly, compared with the length of life, they are more concerned about the quality of life. If a person is in a coma for a long time, such a life has no quality. Western society also has a different view on family responsibilities than the East. It tends to believe that every family member has the right to make decisions based on their own values ​​and life experience. In the West, laws and ethics also provide guidance for such decisions. For example, in some areas, euthanasia and medical termination are legal and recognized by society. Of course, there will also be people in Western society who hold different views on similar decisions. Some people think that this is respect for life, while others may think that this is an evasion of family responsibilities.

Clinically, patients who may be unconscious for a long time are more common in patients with brain trauma, cerebral hemorrhage, cerebral infarction, etc. If the doctor determines that the patient cannot wake up, he or she will often advise the family to terminate treatment. From a medical point of view, the patient's quality of life is greatly reduced, and he or she needs to rely on the care and nursing of others for a long time. Maintaining life may require huge medical resources and manpower investment from family members, which lack medical significance and social value.

In the TV series, the dignity of life and moral choices are the key to the huge controversy caused by Ding Yuanying's abandonment of his father's treatment. The dignity of life is the basic right and respect that individuals should enjoy in society and interpersonal relationships. For vegetative patients who cannot take care of themselves and cannot express their wishes, their dignity of life is difficult to guarantee. Although continued treatment can prolong the patient's life, it may also cause the patient to suffer endless pain and torture and lose the dignity of life. Giving up treatment may be regarded as a disregard and deprivation of the patient's life. This dilemma of moral choice exists not only in the medical field, but also widely in all aspects of social life.

In "The Way of Heaven", Ding Yuanying's decision to give up treatment was based on his consideration for his father's life dignity. He believed that if his father could not recover, then continuing treatment would only cause him more pain and torture. Therefore, he chose to let his father leave this world with dignity. Although this decision caused strong opposition from his family, it also reflected his deep understanding and respect for the dignity of life.

With the development of society, people's values ​​are also changing. More and more people are beginning to pay attention to the dignity of individual life and the right to make independent choices. Traditional family concepts and filial piety concepts also need to keep pace with the times, re-examine and evaluate their rationality and applicability, and face and deal with these issues with a more open and inclusive mindset. This plot in "The Way of Heaven" allows us to have a deeper understanding of the meaning and value of life, as well as how to better balance the relationship between individuals, families and society in modern society.

Author: Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine

Wang Xuemin