How One Person’s Choice to Die Affected our Community

Tim Bowers 1981 - 2013

Tim Bowers
1981 – 2013

Excerpted Responses to a Shocking News Story

Dead Too Soon or Right to Die?
Tim Bowers was paralyzed from the shoulders down when he fell out of a tree and crushed his C3-5 vertebrae. The next day, when his paralysis was explained to him, he chose to have his breathing tube removed and end his life. According to an article in myway (apnews.myway.com), doctors explained to the family that he would be paralyzed and could be on a ventilator for life … that he would never walk or hold his baby and might live the rest of his life in a hospital.

The day after his injury, at the request of his family, doctors brought Bowers out of sedation and told him of his prognosis and asked him if he wanted to decide what he wanted to do. Bowers wanted his breathing tube removed so he could talk. Doctors explained they were not sure how long he would live without the tube. Bowers said he understood. Doctors asked him if he wanted the tube reinserted if he had trouble breathing. Bowers shook his head no.

He died five hours later, surrounded by friends and family.

I can’t imagine how gut wrenching this must be for Bowers’ family, yet the story, which has been covered by over 100 media outlets worldwide, leaves more questions than answers. Did the doctors provide the Bowers family with information about possibilities of a fulfilling life, and were they familiar with examples of high quads living active lives, even if there is no return of sensory or motor enervation?

Wouldn’t it have been better to at least explore the possibilities? Was it a financial decision? Could he have been uninsured, underinsured, in a difficult financial situation or unable to imagine how he might make a living or otherwise provide for his family?

Choosing to end our life is something that can only be exercised once.
— Bob Vogel

Paul Tobin

Paul Tobin

Giving My Uninformed Consent to Die
Many people, including Tim Bowers’ family, will argue that he didn’t want to live as a ventilator-dependent quadriplegic. Having been a quadriplegic for the past 20 years — albeit without need for a ventilator — and as the president of an organization representing 40,000 people with spinal cord injuries and disorders, their families and caregivers, I contend that nobody, including Bowers physicians, could tell what his ultimate condition would be.

In 1993, I shared the views ascribed to Bowers by his family that he wouldn’t want to live as a quadriplegic. I held that view right up until the moment that I heard my neck break and felt my body go limp; lying face down in the surf, cognizant of what had happened, I wanted to live. I was grateful to be pulled from the surf and given the opportunity to live. Over the next few days, I remember coming in and out of consciousness. I was completely paralyzed below the shoulders and would remain so for the next few months. My wife was pregnant; my job was gone; my house was inaccessible; my car couldn’t be modified; everything, every plan, every aspiration seemed to have slipped away. My feelings of being a burden to my family set in — as they may have with Bowers. They would be better off without me. I love them too much to do this to them. I can’t live this way. If given the opportunity at various points after my injury to relieve my family of the burden, or out of my own sense of loss or despair, I might have taken up the offer.

What a life I would have missed if I had been asked to end it all at the wrong time.
— Paul J. Tobin

 

Tim Gilmer

Tim Gilmer

Did Docs Follow Consent Rules?
The University of Minnesota website (www.tc.umn.edu) clarifies the meaning of informed consent (underlined in original): “Informed consent could never be more important than when the outcome being considered is death. If the patient and/or the proxies are to give informed consent to death, they must have a complete grasp of all the relevant medical information. And because the medical facts might be difficult for some deciders to grasp, sufficient time must be allowed for all concerned to become educated to whatever extent is possible for them.”

While Bowers may have been competent to decide who would benefit from his will, a “complete grasp of all the relevant medical information” pertaining to his spinal cord injury is far more complex and difficult to master. Most doctors and nurses do not know enough about SCI to competently treat a newly-injured person. That is why we have rehabilitation hospitals and model SCI treatment centers. That is where the experts are.

What is most reprehensible, in my opinion, is the role the hospital and doctors played, or rather, didn’t play. What was the big hurry in forcing a sedated patient to wake up and make such a decision? Where was the Hippocratic Oath — the moral lynchpin of the medical profession — to first “do no harm,” when it was most needed?
— Tim Gilmer

Selected Reader Comments From Facebook

His life, his choice. Perhaps he saw it as a life of existing, not living. There is a big difference between the two.
I support his choice.
— Dale Gee

The man was given one reality. Death. Did he or the family know anything about disability? In a word, no.
— Bill Peace  (See Bad Cripple for more on Peace’s views: badcripple.blogspot.com.)

First answer is usually right and it was his choice, no one else. I have had to fight with doctors about being DNR. This is my choice. Tim made his choice. Comfort care only. He slipped away peacefully in his sleep.
— Marcia Staunton

Catherine Haburay Gibbons

Catherine Haburay Gibbons

I have been debating this for two days. No way should he have been asked so soon. I woke up trached with tubes coming out everywhere. There was no way to tell what could be done. He just quit, and so did his family.
— Catherine Haburay Gibbons

C4 Quad here. We chose to live, but my family would have pulled the plug if I stayed on a vent. Choice!
— David Stevens

The thing is if you didn’t experience a near death, and a vent, as I did, you would not know what you really would do. One person helped me — a very kind stranger … and the look in my 18 year old’s eyes … so many things can alter a choice. That is why laws exist. Bacteria to the brain has been recently proven to cause suicidal thoughts, lack of judgment, memory, delusional thoughts etc., so if the brain is trying to fight, how would you know? Time [is needed], and counseling by volunteers with their level of SCI. A para has no clue what C4 is like, just as my complete C4 was so different than incomplete.
— Lisa Woods Tremaine
You can’t mindfully choose that quickly. I see it as pressure to suicide.
— Lynne Dorr

Karen Halgren

Karen Halgren

Agree, it is about choice, but I don’t think it’s something that should be brought up when someone is highly sedated. I know, I have a DNR in place and my family knew even before I was injured that I did not want to be kept alive with machines. When first injured they didn’t know what my prognosis would be — doc didn’t think I’d make it thru the night but here I am 11 years later! SO thankful … yeah it sucks to be in a chair but I’m here … everyone has a choice to be here or not. I think it should be a personal choice but not while sedated … sad story all the way around … RIP sir …
— Karen Halgren

For starters, this man was brought out of sedation and told that he would never be able to hold his soon-to-be-born baby, would never be able to give hugs, was told that his quality of life and life expectancy were cut dramatically short. HOW DARE THEY??? No one knows this, no one! Only God knows what his life will be like in the future! Maybe they had talked about this scenario before, but they should have waited to let him make this decision. Was he vent-bound for the rest of his life? Maybe, and maybe not! They did not know for sure yet! This man wasn’t in the right frame of mind to make such a decision, not at that time anyway! His child will never be able to hear his voice, to know its daddy! He will never be able to see his child’s face, to know who the child looked like, to hold that child, and yes, he could have held it! He could have hugged, he could have lived a long, healthy, happy life in a wheelchair! This whole situation makes me angry and it was NOT done in the right way!
— Alicia Barnes

It’s all about choice.
— Vicki Garrett

Comments From NewMobility.com

I am a C3 quadriplegic and I was almost “switched off” by the director of intensive care in a large regional hospital in Australia, just like Tim Bowers, within 24 hours of my accident. Thirteen years later I’m alive and thriving, thanks to a determined family member who was a human rights lawyer, and my girlfriend. In Australia, spinal cord injuries are not supposed to be assessed for between six and 12 weeks after the accident as it’s not known how well peoples’ bodies respond to the injury. I was supposed to be a C3 complete, which would have meant a life with a machine breathing for me, but great doctors and allied health staff at [the] intensive care and spinal unit encouraged/drove me to learn to breathe again. Thirteen years later I’m still paralyzed from the shoulders down, drive my wheelchair with my chin and have a very worthwhile life.
— Sean Fitzgerald

I thought of you when I read this story. Dead at 32. Just an enormous tragedy. I wish he had an opportunity to meet you.
— Samantha Connor

I believe it was too soon to make that decision. I work at a major spinal cord rehab center [Craig Hospital] and have seen many examples of initially complete injuries ultimately classified as incomplete. And, of course, I’ve been privileged to witness the amazing resilience of those with complete injuries who continue to live and love large.
— Tammy Chamberlain

We don’t always get to choose the changes that impact our lives, but we can choose to be the change we want to see in the world. This is the motto I repeat every chance I get so that I don’t forget it myself, but moreover so that others can see that everyone can have a positive impact on other peoples’ lives regardless of their physical abilities. The chair is nothing more than an accessory; we design the wardrobe and decide how we’re going to show up dressed everyday!
— Shaun Hogan

Everyone should be able to make their own choice, ideally. It’s the timing of this, the way they made him decide right then and there in likely a post-sedation, terrifying haze, without presenting more detailed possible alternatives, that makes this wrong. It was not an informed consent.
— Alejandra Ospina

Wow. I can’t believe the whole family (including him) made that decision so quickly. After ANY life-altering event, death of a spouse, divorce, loss of a long-term job, you don’t make any decisions quickly; you wait and let the emotions settle down. I’m still stunned about this one.
— David Lark

Why is it anyone’s concern but his? Why should anyone have to “justify” their choice to another … under any circumstances? Why can’t a person choose to die peacefully and painlessly anytime they so choose “the right to die”? Remember the old Twilight Zone where the prisoner and the professor each went to their own heaven and hell … and it was the very same place?? Who are we to speculate, let alone decide for another person?
— Gary Wohlers

No one is saying that the decision was anyone but Tim’s. What most of us are saying is that the decision was FAR too premature and with far to limited information to even begin to make a decent prognosis, let alone a life or death decision. The fact that the young man was ABLE to make a decision should be called into question. Bodily trauma is inevitably connected with emotional trauma and unclear thinking.
— Kathleen Kelley

Often we do not know how we will be in a situation until the shock has worn off.
— Tashauna Swanson

As far as we know, he was only aware of the imagined negatives. Sometimes it’s hard not to hate doctors who view us as simply people they have failed to fix and don’t want to be reminded of it.
— Mary Elizabeth McKnew

I don’t get why you or anyone else should be “comfortable” with a decision that has nothing to do with you …
— Mary Yard

What is the difference between what these doctors did and what Dr. Kevorkian did?
— Dave Velguth

The difference is they stopped treatment, while kevorkian actively helped them die. They …  didn’t even give this guy a chance to adjust to his situation. I was sickened by this story.
— Pam Velguth

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  1. Efren Caldera says:

    I personally agree that Tim Bowers made the right decision for himself. That is the majority of opinion on how disability is seen through the eyes of the “regular”, we are not out there enough to show that we can do every day and out of the ordinary day things. People still feel that they should feel very sorry for us. Yes, there are still places of employment that think twice about hiring a handicap person. And, maybe that’s got to do with people having become too dependent on government’s help. Get a Job Loose Your Benefits. Really??!
    No Mr. Bowers, it was not the end, but the beginning. Too bad you could not see beyond that.

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