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Argentine law states that when a patient suffers an “irreversible, incurable or terminal” disease he may refuse to keep him alive, although “its wording is ambiguous", say the specialists.
“A terminal pathology is one that progresses and leads to death, while the vegetative state does not advance,” explained Carlos Cafferata , head of the Palliative Care Section of Italian Hospital .
Cafferatta , who works with cancer patients with neurodegenerative diseases and other fatal conditions, considered that “it is not bad to maintain hydration and nutrition in a person in vegetative state”, referring to the case of the Frenchman Vincent Lambert, who died on 11 July after having remained in that condition for a decade.
The 43-year-old man, who had become quadriplegic in an accident, became a symbol of the debate around dignified death and kept his own family facing, although life support was finally withdrawn at the request of his wife and against the will of his parents.
“A vegetative state is sometimes irreversible, but not progressive. Lambert could have continued to live as long as they kept him hydrated and fed, but it is a controversial case that depends on who interprets the law,” the doctor argued in dialogue with this agency.
For lawyer Ignacio Maglio , head of the Department of Legal Medical Risk at Hospital Muñiz , “there is no documented case in the world that a person has recovered from a persistent vegetative state.”
“In Argentina we have two major regulatory frameworks that make it possible to make decisions at the end of life: the so-called law of dignified death, which is actually an amendment to law 26,529 on patient rights, and the provisions of the Civil Code in force since 2015 in its articles 59 and 60, where refers to the withdrawal of life-support measures,” explained counsel.
Maglio explained that euthanasia, that is, death “caused directly at the request of a patient through the administration of a toxic or poison in deadly doses,” is only regulated in Belgium, Sweden, Holland and Colombia.
“In today's Argentina euthanasia amounts to homicide, but at some point we are going to have to discuss the voluntary interruption of life, as is being discussed the termination of pregnancy,” he said.
Lambert's case is similar to that of Neuquino Marcelo Diez , who spent 20 years in vegetative state after a car accident and died in 2015.
The case came to the Supreme Court of Justice of the Nation , which recognized the patient's right to “decide on his own dignified death” and accepted the statement of the sisters, who claimed that before the accident the man had stated that if at any time was going through a similar situation “I did not want it to be kept artificially alive”.
“In both the case of Lambert and Diez , the only objective of keeping them alive was to prolong a painful, burdensome and unworthy agony. It is regrettable that these cases are prosecuted, something rare is happening if we have to ask the judges for permission to die in peace,” Maglio criticized.
Asked about the possibilities of reversing a vegetative state, neurologist Alejandro Andersson said that “a month there is a chance of 18%, at six months 3% and henceforth the chances are infinitely lower”.
“The vegetative state today is called wakefulness without consciousness, because they are patients who have a sleep cycle and another of wakefulness, open their eyes, but have no explorable consciousness content,” he explained to this agency.
Andersson , director of the Buenos Aires Institute of Neurology , said that “when one studies a patient can know what degree of consciousness he or she has”;
“In Argentina the only irreversible 100% is brain death. The rest of the cadres are probably also, but as doctors we are obliged to keep the patient alive,” he said.
The Civil Code states that “every person capable of legal age may have advance directives on his/her health”, a measure that Maglio considered “fundamental"
“It would be important that we all leave in writing the indications on what to do if we lose consciousness, so that no one has our bodies and our will is respected,” he added.
Publication Date: 03/08/2019
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