When life support is questioned early in the care of patients with cervical-level quadriplegia

Article Abstract:

The decision to withdraw life support in patients with a complete cervical spinal cord injury should not be made until the patient has finished rehabilitation. Patients still in intensive care may not have the cognitive and emotional capacity to fully grasp all aspects of the decision to refuse treatment. Patients in intensive care may suffer from sensory overload or understimulation, sleep deprivation or confusion. They frequently suffer grief and major depression and are heavily medicated. All these factors may influence their ability to think clearly. Furthermore, before any treatment decisions are made, patients should be fully aware of the long-term physiological and psychological consequences of their spinal cord injury. Misconceptions are common, including the general belief that people with spinal cord injuries have poor quality of life. In fact, the suicide rate among quadriplegics is low, and the overwhelming majority say they are glad to be alive.

Care and treatment, Quadriplegics

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The legalization of physician-assisted suicide

Article Abstract:

There appears to be a shift in right-to-die laws. Instead of making a distinction between withdrawal of treatment and suicide, an Oregon law and two court decisions use terminal illness as the determining factor. Any terminally ill patient may choose to end their life whether they are suffering or not. However, patients with a non-terminal illness may not request physician-assisted suicide no matter how bad their suffering.

Assisted suicide

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