Re: Death of Hisashi Ouchi

[Dov Brickner <brickner@mail.inter.net.il>]

At 14:25 21/12/99 -0600, you wrote:
>
>In any case this reverts back to similar situations in the 
>elderly or otherwise very ill, who themselves cannot make 
>informed decision about heroic life support/life saving. 
>His family could be the people saying "try and save him." 
>
>If nothing else its a good reminder to spell out your own 
>preferences on the issue with friends and family before it 
>is needed. 
>
>I personally would prefer to be allowed to die in this 
>or similar situation.
>
>regards
>Andrew
>
Sorry - this is an entirely different situation, very remote from the
ethical problems concerning  elderly pastients or terminally ill patients.
The victim was a very young man and persumably otherwise healthy. This fact
by itself will  direct every physician to treat him heroically.  In
contrast to most terminal illnesses , accident victims should be given the
beat and most extensive care, until the caring physician is absoltely sure
there is no chance to save him
Acute radiation syndrome after such high level exposure is NOT a prevalent
situation , one that you can find data and make prognostic estimation to
base your decision of treatment modalitis. No patient survived exposures
above the order of 9-10 Gys to the best of my knowledge and Mr Ouachi was
the first to survive such a long period. Therefore the medical crew caring
for him had no precedants to base the decision to  continue intensive care
or not. They had to rely on clinical parameters like evidence of brain (or
other systems) damage .
Yet , the discussion of these ethical aspects of radiation accident is very
important. I think it is time to learn the lessons not only how to treat
better the victims (was the decision to transplant stem cells justified IN
RETROSPECT?) but also on what criteria to base the decision not to treat. 
Dov (Dubi) Brickner    MD
Beer-Sheva  ISRAEL

brickner@mail.inter.net.il
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