Say a parent of yours has been critically ill for a few months. S/he’s bed-ridden, unconscious and on life support (oxygen tank).
A doctor says that if the oxygen is taken off, he will die. You have limited financial means and the medical cost will be paid by you and/or your sibling(s). Will you consider making debt if the medical cost is too much to handle?
What’s best to do in this situation, to continue or discontinue the life support?
it’s a case of ascertaining if impermanence is being artificially prevented from taking its natural course. Sentimentality should not be allowed to override reality. From the information given, it sounds like life support should be discontinued.
It is a perversion to regard what is impermanent as permanent (AN 4.49).
I’ve heard Ajahn Brahm say something along the lines that if you sit with the person and just ask them what they want, some part of you will just know what their answer is or would be and whether or not they are still present.
I’ve read a book by Nils Birbaumer ‘Your Brain knows more than you think’ where, in the course of studying locked-in syndrome, he discovered that people in that state are actually happy to be there. He talks about the happiness of not having to make choices.
He also describes turning off life support on someone is akin to suffocating or starving them to death, which wouldn’t be very nice if they did have awareness but the doctors couldn’t tell that was the case.
Either in that book or another neuroscience book by someone else (sorry, I can’t remember) I have also read that there are cases when we think the person can’t hear us talking about them and their condition, very often they can.
Given all of the above, I don’t think my conscience would permit me to turn off the life support unless I had that gut instinct that they really were already gone and I really had confidence that I was truly not acting from money as a reason. Of course, I’m priviledged to be in a country where medical out of pocket is not as much as it would be in other countries.
Of course, this is complicated when you are not the sole decision-maker as siblings may disagree and there may potentially be ongoing friction with those siblings or a family feud arising!
It sounds like a truly nightmarish situation to be in and I’m hoping it is a merely hypothetical one and not actually happening to you!
Have you asked for material help? I am hoping pride, anger, or other defilements are not barriers or fuel in this situation.
Two (at least) relevant threads of Buddhist ethics apply: what is best to do in this situation for any life, and what is best to do for a parent’s life?
Discontinuing, as well as continuing, would likely have psychological and other unavoidable impact on the actors. These have lasting effect, in this life and any others. So I would consider financial debt not the most worrisome cost.
You mention “bed-ridden, unconscious and on life support (oxygen tank)” but not pain.
Please read this
If a parent is captive in a bedridden body, or both the parent and child are captive to a situation, it may be an opportunity to share Dhamma. Perhaps you already are sharing that opportunity.
At the time when death was approaching, the Buddha chose not to extend his life:
“The third chapter (DN 16), almost exclusively, is devoted to depicting the circumstances connected with the Master’s relinquishment of life, which is the dramatic culmination of events. It overwhelmingly drives home the purely metaphysical significance of the Parinibbana, or at least ought to do so. For the Buddha neither succumbed to his fatal illness nor did he give way to the appeal of Mara (which is identical with the non-appeal of Ananda), but sovereignly let go of existence at a timely hour, just as forty-five years earlier, on becoming fully enlightened, he had duly taken upon himself the wearisome task of teaching men. This fact is most thought-provoking, and consistently leads to the conclusion that by his Parinibbana, indeed, the Buddha bore the last and highest possible testimony to his Teaching, which permits of no lingering inclination to self-preservation and continuance, but on the contrary reaches the highest exultation ending it all. The Master’s Parinibbana is, therefore, the one sorrowful event in the history of Buddhism that turns out, in its true meaning, to be really the most blissful.”
— Sister Vajira
"Do not trouble yourself, Evil One. Before long the Parinibbana of the Tathagata will come about. Three months hence the Tathagata will utterly pass away.”—-DN 16
Maybe the law of the land where such scenario takes place can have an influence on the decision. For example, in secular societies, civil law and what is currently known by doctors might have a stronger influence on such decisions than religious or spiritual interpretations, and vice versa.
To treat people according to the customs of which they came to witness, believe in and practice is a sign of respect when we have to take decisions on their behalf. If the patient represents a minority in his group and we happened to know what they believe in relation to issues of life and death, it can be a good practice to make the decision based on their beliefs, not ours.