Euthanasia and Faulty Medical Diagnoses

There are numerous reasons why the legalisation of euthanasia should be rejected. I have sought to make that case in some forty other articles on the topic found on this website: https://billmuehlenberg.com/category/ethics/euthanasia/

One reason why we should be very cautious indeed about going down this path is the issue of faulty diagnosis and predictions. To terminate a patient’s life, a doctor must have pretty good assurance of his diagnosis/prognosis. But it seems that this has not always been the case.

For example, some surveys have found that one-half of responding physicians said they were not confident to predict that a patient had less than six months to live. As one particular study has found (published in the British Medical Journal) there is an astonishing level of misdiagnosis of things such as PVS (persistent vegetative state) and comas.

The study of 80 patients supposedly in a deep and presumably irreversible form of coma found that three-quarters of them had been misdiagnosed. Many of the patients had either woken up spontaneously or had shown clear signs of brain activity.

And another study found that eleven patients admitted to a New York hospital who were diagnosed as having “advanced cancer in its terminal stages” did not have cancer at all. Indeed, as one doctor put it, “Significant numbers [of patients] have been told by doctors that they have only months to live, and have lived on, often with a good quality of life, for many years. As with capital punishment, if you get it wrong, it’s too late!”

While getting things this wrong may be somewhat rare, such cases are still common enough to express great caution. Consider just a small handful of further examples coming from overseas. One is a tragic case from the UK in which a Belgium man in a comatose state for 23 years was fully conscious the entire time. He tried desperately to communicate but could not. One report on this goes on to state:

Although tests at the time showed that he was essentially “extinct,” newer tests conducted just three years ago showed Houben’s brain was functioning normally — and his renewed ability to communicate is something he describes as a “second birth.” “I shall never forget the day when they discovered what was truly wrong with me – it was my second birth,” he told the paper. “I want to read, talk with my friends via the computer and enjoy my life now that people know I am not dead.”
British neurological expert Dr. Steven Laureys has described Houben’s case in a new paper and said, “Medical advances caught up with him.” The paper indicates doctors used the internationally accepted Glasgow Coma Scale to assess his eye, verbal and motor responses, but the results were incorrect. Laureys says physicians need to not be so quick to label patients as in a vegetative state, because such a diagnosis can be incorrect.

Another article on this adds more frightening detail of the ordeal he endured: “Rom Houben, 46, had no way to tell his family and doctors he could see them and hear what they were saying after waking up following a bad car accident in 1983. He spent more than two decades in excruciating isolation until a neurologist realised he was not in a coma — just unable to communicate.”

One man from Arkansas who was barely conscious for twenty years because of a severe brain injury recently stunned doctors by regaining speech and movement. It seems his brain rewired itself. And an English woman in a vegetative state after a car accident has amazed doctors by responding to voices.

Consider another sobering case, this time of an Italian man who chose to be put to death in a Swiss suicide clinic. It turns out that a faulty diagnoses led him to take such a drastic action. As a local Swiss paper stated:

The father-of-one took the decision after a wrong diagnosis from Italian and Swiss doctors, his family’s lawyer Michele Roccisano told Italian newspaper Corriere della Sera. An autopsy carried out by the University of Basel’s Institute of Forensic Medicine found that D’Amico was not suffering from a life-threatening illness at the time of his death. Roccisano has called on the Italian and Swiss authorities to examine D’Amico’s medical records to determine what went wrong.

Another case comes from the UK: An English teenager involved in a car crash and in a coma was said to be beyond hope by the medical staff, and his parents were even asked to allow his organs to be donated. But they refused, and he is alive and well today. As one report says:

They were told there was no chance of their son surviving after he suffered devastating injuries in a car crash. But Steven Thorpe’s parents refused to give up hope – despite four specialists declaring that the 17-year-old was brain dead. Convinced they saw a “flicker” of life as Steven lay in a coma, John and Janet Thorpe rejected advice to switch off his life support machine. They begged for another opinion – and it was a decision that saved him.
A neurosurgeon found faint signs of brain activity and two weeks later, Steven woke from his coma. Within seven weeks, he had left hospital. And four years on, the trainee accounts clerk says he owes everything to the persistence of his parents. From his home in Kenilworth, Warwickshire, Steven, 21, said: “I feel so lucky that my parents wouldn’t take no for an answer.”

Or consider an even more recent case. A 14-year-old girl in Michigan was shot and declared to be brain-dead. She was about to have her organs harvested when suddenly she showed signs of life. As the hospital staff were preparing to remove her organs for donation, she squeezed her mother’s hand.

As the news report continues, “Kopf squeezed her mother’s hand again when the mom asked if her daughter could hear her, [Michigan State Police Lt. Dale] Hinz said. She also gave thumbs-up signs with both hands when a doctor asked her to give him a thumbs-up if she could hear him, Hinz said. She was then rushed into surgery to treat her wounds.”

Let me offer just one more example of how wrong medical experts can get things, this time from Denmark. A report on this is worth quoting from in part:

A documentary was aired earlier this month which showed family members reacting in anguish to the news that their 19-year-old daughter was brain dead after a car accident, agreeing to donate her organs and allowing doctors to turn off her respirator. About 1.7 million viewers tuned in to the heart-rending drama. But Carina Melchior did not die after her respirator was removed. She is now undergoing rehabilitation and may make a full recovery. About 500 people immediately removed their names from Denmark’s organ donor register. Doctors at Aarhus University Hospital were embarrassed by the incident. “We are overjoyed that the young woman survived and that she is moving on after the accident,” Claus Thomsen, the hospital’s chief medical officer, said. “But we made a mistake underway and made the family believe that their daughter and sister would die.”

This is not to say there is no place for organ donations and transplants. But that would have to be the subject of another article. What is being said here is that such disturbing stories are not entirely rare. They seem to happen often enough to give us all pause for concern.

It should go without saying that with such a worrying range of faulty or uncertain assessments of a patient’s condition and likelihood of survival, it surely would be reckless to legalise euthanasia at this point.

(Note, all the cases and quotations presented here have been fully documented and referenced. You will find them all in my forthcoming book, The Challenge of Euthanasia.)

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