Category Archives: First Year – Getting Acquainted

The excitement of having started medical life.

Euthanasia-choice to die

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This essay was given for the Biomedical Ethics Essay Competition 2010 organized by King Edward Literary Society (KELS)

By Farkhanda Qaiser

 

It was early spring. The birds were twittering on the brightly colored trees. A cool breeze was blowing at that ungodly hour of 5 in the morning. She’d suddenly woken up with a premonition that something was wrong. However the moment she stepped out in the garden, all her fears were dispelled.

 

“What could go wrong with such a beautifully perfect day?” She thought.

 

Alas, her optimism didn’t bear any fruit. While preparing breakfast for her two young sons, she suddenly collapsed.

 

All that she remembered after that was the wailing siren of the ambulance and the bustling activity of frightened people shouting at each other.

 

She had been diagnosed with Blood cancer. Doctors said that the cancer was in the last stages and she hadn’t long to live. She was still unconscious after the blood transfusion and so entirely dependent on the life support equipment for the numbered breaths of her life.

 

At this point, a crucial question arose. As there was no hope whatsoever of her living through this predicament, so should the life support be withdrawn from her to relieve her suffering?

 

The medical term used for this condition is Euthanasia which is the Greek for “good death.” To be more precise, it is the intentional killing by act or omission of a dependent human being for his or her alleged benefit. There is a great debate regarding this issue among the medical, legal, religious and political communities of the world. The huge media hype created around it always amused me because I felt that the verdict was very simple. Euthanasia should be banned once and for all because it was highly unethical to take someone else’s life for one reason or the other.

 

However once I started researching Euthanasia, I realized that the matter was not so straightforward. It was the perfect example of a labyrinth within a labyrinth.

 

To begin with, Euthanasia is classified according to different parameters like choice and method to kill.

 

According to choice, it may be voluntary or involuntary. Voluntary euthanasia a.k.a. Physician assisted suicide (PAS), as the name suggests, is when the person who is killed has requested to be killed. It’s legalized in Belgium, Netherlands, Albania and US states of Washington and Oregon.

 

The desire to die could be due to a number of reasons. The patient may feel that he’s a burden on his family either emotionally or financially or he could be pressurized to sign his own death will. Or worse still a doctor’s solemn pronouncement of him being a hopeless and incurable case may have catalyzed his decision. Should he be listened to?

 

Strong proponents of democracy would immediately nod, citing personal autonomy as the reason. They suggest that every person has the right to die and nobody can impinge on this fundamental right of life. How ironic! The opponents would cry. Which right are you protecting? The right of life or death? Which is more sanctimonious? And who would carry out the act? The doctor? The person in whose hands people so trustfully put their lives. Once he has been established as the taker of lives, how will the aggrieved patient go to him with hope of cure? The healer would now be the dealer of death. Moreover he’d be openly violating the “To please no one will I prescribe a deadly drug nor give advice which may cause his death…” clause of Hippocratic Oath that he’d taken at the start of his practice. And if he has dared to violate one clause, it wouldn’t be long before all others are stricken down one by one. Even thinking about the possibility sends a shiver down my spine.

 

However the next type is more macabre than the first one. It’s called involuntary euthanasia. In this case the person who’s given the death sentence is not in a mental or physical condition to give any opinion about the matter. He may be post traumatic comatose, a newborn with a severe spina bifida, or a terminal cancer case in severe distress due to pains. The decision is then made by the family members. Who could be better suited for this post? You might ask. And the pessimist that I am. I’d say who could be worse? The world has become so materialistic that son can kill father to gain his share of inheritance, husband can kill wife to acquire her property and every Cain can ruthlessly murder his brother Abel for ulterior motives. For the majority, money is the driving force. These money makers should not be appointed as the decision makers of such a sacred thing as life. What to do, in that case? Let life and death take their course at their appointed times. Do not try to be God. If a person is destined to die a painful death, then do not interfere with his fate. Maybe he has been given an opportunity to grow in wisdom, character and compassion. Life is not futile. It teaches its lessons at every step. And it’s said that suffering makes a person reach the highest and noblest points of what they are. So we have no right to take that away from anyone!

 

Neither can we take someone’s life by omission. i.e. by intentionally not providing the necessary and ordinary care, food and water. It also includes withholding of common treatments, such as antibiotics, necessary for the continuance of life. This classification of euthanasia is based on the method to kill which could be by omission or action.

 

Sometimes doctors plead the lack of public financial resources to refuse life support equipment or tube feeding for terminally ill patients. They solemnly declare that necessary medical procedures like x-rays, prescribed drugs or lab tests could cost ranging from $50,000 to $100, 000 and this huge sum could be used instead on other types of care, like prenatal, where it would save lives and improve long-term quality of life. Moreover, the already under staffed hospitals are over worked which affects the quality of care that they provide. So attending to dying patients is not the best use of medical staff. These patients should be assisted to a speedy and painless death. They further argue that such patients could be used for organ donation which is a very noble cause. In all my research, these are the only few arguments in favor of euthanasia which sound convincing. However, this could make the financially weak people more insecure and susceptible to mishandling by authorities. And this goes against the socially accepted fact that all human beings are to be valued, irrespective of age, sex, race, religion, social status or their potential for achievement. Moreover the slippery slope argument is valid here which states that if we allow something relatively harmless today, we may start a trend that results in something currently unthinkable becoming accepted.

The example of such a trend is the last type of euthanasia which is Active euthanasia. It is the use of lethal substances or forces to kill. It could be a lethal injection or euthanasia machines like Thanatron, mercitron or deliverance machines. They use diverse mechanisms to end life like pressing a button that release deadly chemicals or a mask fed with a canister of carbon monoxide or a notebook computer and software titled “Deliverance”, which asks the patient a series of questions, and automatically administers a lethal injection of barbiturates if the correct answers are made, respectively. Imagine if all of this were legalized! Hospitals and medical stores would become the devil’s shop full of such deadly instruments. Where would suffering humanity then go? They’d be led to believe that it’s better to be dead than sick or disabled. But that is not what hospitals and doctors are supposed to do! Instead they should provide intensive training in pain control, compassionate care and alleviation of fears. It is believed that the unbearable pain can be controlled to tolerable levels if given proper care from the hospital staff. In the words of Alison Davis, who suffers from spina bifida, hydrocephalus, and multiple other disabilities, May 30, 2009:

“In my experience, when the pain is bad, what I need is not to be told I’m burdensome and it’s my choice whether I want to live or die, and that perhaps I would be better off dead. What I need is to be surrounded by people who tell me, yes, my life does have value, and I’m not burdensome … they can’t take the pain away, but sometimes it’s not the pain that hurts the most, it’s the fear of being abandoned.”

Moreover the focus should be on finding a treatment for incurable diseases rather than disposing off the patients with such diseases. Visualize the impact the physician role models carrying out euthanasia would have on students and young health care professionals. Would we devote time to teaching students how to administer death through lethal injection or save lives? It would be very difficult to communicate a repugnance to killing in a context of legalized euthanasia.

Mercifully, this form of euthanasia is illegal in all countries of the world. But the debate is not just about the legality of euthanasia but also about its ethical viewpoint. If once the doctor has accepted the fact that he can end life, no amount of rules or regulations will protect the public and with that I rest my case.

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And We Won

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This post was published in KELLOGS on 29/6/2010

By Farkhanda Qaiser

Ever since Kellogs has been launched, I have been nagging myself to make some contribution but something or the other crops up. Either there is a sub stage/module/stage or if not then the net doesn’t work…! So I decided to wait for the summer vacations and here I am to regale you with a success story…!

I’m still mentally occupied by our roller coaster of a year and the outstanding things we did. Today I’ll talk about one of those events…i.e. Bake Sale!

Much like every other event, bake sale also started with the posters being plastered all over KE. Zero point, opposite anatomy lawn, on trees, on notice boards and every other place where Kemcolians could chance their eyes on. ‘Much awaited event of the year…just a week away’ was the oft-repeated announcement. From the day that we were allocated the day for our bake sale, we started the preparations. The first task was to inform the class which in itself was a daunting one. Anyone who has ever made an announcement in our class would definitely know what I mean. You can expect anything from the audience: Boos or applause; things like shoes, over-alls, physiology books or even garlands flying your way; but most surprisingly songs being sung for you…! (And trust me; the last one is NOT an exaggeration!) During one of the bake sale announcements, the poor announcer was honored with ‘Paisa paisa krti hai tu, paise pe marti hai tu’ chant among the guffaws of those who heard it…! Yes, very embarrassing.

But the SPWS organizers were not the ones to give up. We moved on to the next phase of choosing a theme. We were told it wasn’t necessary. Many classes didn’t have any theme at all. Ha…! That did it. “We will be different!” roared everyone, “We will have a theme that no one has had before.” And so after much brainstorming, we did just that.

Then we prepared hand-made cards for more than 30 teachers and that too in DH. The enthusiasm was contagious. By now, everyone wanted to be a part of this event. All students were seen hustling and bustling around anatomy and even physiology departments to dispatch invitations to the faculty. Among the teachers, some were pleasantly surprised at being remembered; others avoided us like a plague in case we asked them for donations! In the meanwhile, the menu had to be decided too. Boys excused themselves saying, it was the girls’ domain. Girls wanted time to think. We, the organizers, were in a fix. Much shouting and pleading followed. Finally this matter was also resolved. As we’d chosen a unique theme so we also had to make decorations. Suneeba took the responsibility and thus was seen scurrying back and forth to anarkali.

At last the Big day arrived. Any fears of our failure were dissuaded as soon as they crossed our minds because the bake sale started even before its time. The culinary delights cooked and baked by the brilliant chefs of the country were irresistible. Around that time, our chief guest arrived. Our very own Ma’am Atiya – the head of Anatomy Department. Yes, we were giving her a surprise birthday bash. And that was our theme. Balloons soared in the air, gift boxes were stacked near the stalls and all the organizers wore birthday hats! Ma’ma Atiya’s real birthday was the next day but we decided to celebrate it in advance. She was definitely caught unawares but decided to go with the flow. And believe it or not, she reluctantly wore a humongous birthday hat and cut the sumptuous chocolate cake to the roaring cheers of all Kemcolians gathered in the pharmacology lawn. Thus our bake sale had been inaugurated. In view of the sweltering heat of May, we had imported the renowned Lemonade and Gola stalls on cartwheels from Anarkali. But hold it, that was not all we offered. As we’d had no funfair so we also set up some non-food stalls like palmistry and face-reading. Thus our bake sale stretched on for more than 3 hours in which there was no distinction between the nerds and cool dudes and dudettes of our class. All were seen making announcements in street-hawker like voices, competing to bag the most money and last but not the least taking pictures with their beautifully embellished stalls. This day was definitely one of the most memorable days of my life! And I’m sure that’s true for the entire 1st year.

In the end, all our efforts paid off when 1st year was declared the winner for generating more than 80 grand. Never before had any single class raised such a huge amount in a bake sale! But we did it all under the able supervision of Humaira Sarfraz and Ammar Afzal – the SPWS GR and CR of 1st year. Thank you guys for entertaining us so thoroughly and that too for a noble cause! (The funds were used to buy pediatric ventilators for Lady Wellington Hospital.)

Altapete – 1st Year Class Diary

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This article was printed in Kemcol 2010, the official annual magazine of King Edward Medical University.

 

According to one senior: “1st year ROCKS…! You guys make me wish I was a part of your class!”

Yes, we are unique and very lively but our year began much like that of every 1st year. You guessed it right. Ragging! Boys were seen begging from girls; some were made bakras and sold to seniors for a meager amount; others got the rakhi tied on their arms and yes, of course, the ever famous climbing up on the roof of anatomy department followed by “KE mere baap ka hai, sab log nikal jao yahan se…!” chant and singing the song “Main uddi uddi jawan hawa day naal.”

As the 150th Sports week celebrations arrived, a group was always seen huddled in any nook or corner of KE vociferously arguing about the class theme which was finally decided to be ‘Pirates and Princesses’. The pirates wore the specially designed pirate hats and carried the artificial swords. The princesses were beautifully clad in gowns and frocks and made their entry amidst the loud cheering of boys and girls alike. Then there were sword fights, treasure hunts and of course photo shoots! Seniors were seen flocking to our stall to take pictures with our pirates and princesses! 1st year had made itself known…and with a bang!

A similar response was witnessed after the 1st year play, “Komplein kab phootain gi?” The hosts couldn’t help commending the fine acting of the young cast and the entire crowd encouraged them by hooting and screaming their lungs out!

It was also a day of revelations when we discovered the nimble athletes of our class. Among the boys, Haris Bilal, Abdul Rafay and Waqas Tariq won medals. Whereas among the girls, Suneeba, Sundas, Fatima tuz Zahra and I performed the same feat. Though these wins were not without the prayers of the rest of the class which actually performed an ijtamai dua for our success. Next up was the colour day in which we stood out by our purple dressing and decoration. Ma’am Zahra especially lauded us for our clever choice. More so, because we had hailed her advice by not wearing the dull black!

After the end of sports week, our class celebrated some days of its own. First up was the anti-valentine’s day by the boys. They all wore shalwar kameez and white topis and chanted slogans the entire day both in and outside the class rooms. It was definitely a sight to watch and enjoy. Another day was the funny theme cum mismatch day by the boys. Vests on top of shirts, shorts on trousers, ties on kameez, funny hats…and what not! The girls, however, believed in commemorating days of national significance like the 23rd March by wearing the Pakistani flag colors and tying green arm bands. Even Sir Shahid appreciated our patriotism! Lastly we celebrated the black day by donning black to depict our feelings of suffocation and boredom in the early months of MBBS.

And this brings us to our own class function! All credit goes to our CR, Taimur Haider who made this seemingly impossible task possible! However another first awaited us here! The arrival of the head of Basic Medical Sciences to such an event for the first time ever! As he had graced us with such an honor therefore we gave him standing ovations countless times so that he’d have a soft corner for us during the Profs. After the initial surprise, the dust settled down and the function proceeded normally. The highlights were the not-so-melodious singing of Haris longus, Sohail Waraich’s/Arafat Farooqi’s interview with the 5 most popular students of our class, the scam video of the boys made by the girls and of course the titles given to girls by boys and vice versa.

In the meantime, we experienced the ‘customary firsts’ attributed to the first year of MBBS:

The first time we saw a cadaver while hovering behind each other and then grew courageous enough to start dissection; the first time we touched a frog with bare hands and then smacked the daylights out of it; the first anatomy substage and our fear of the unknown; the first failure that gave rise to shock and denial on our part; the first time we were called ‘doctor saab’ and we ignored the voice thinking that someone else was being addressed, the first trip to al-Karim which was far from the last and the list goes on and on. All these firsts have left deep and far-lasting impacts on our minds and souls and have become an integral part of who we are: the cream of the nation, the best of the best, the Kemcolian batch 09-14!

On the other hand, there were some eccentricities which can only be linked to our batch; the fact that we were the first class to have anatomy, physiology and biochemistry modules at the start of every month! All our hue and cry at this atrocity fell on deaf ears and we were forced to appear for 18 modules along with 8 anatomy substages and 2 stages! (These facts and figures are valid till before the summer vacations) Then the elections and re-elections of CR and GR first under the supervision of Sir Zubair, then Ma’am Atiya. Both times, the girls voted for a day-scholar – Saira Afzal – to become the GR and so another Kemcolian tradition was broken (You see, because GR is usually a hostelite)

Now, we move on to the busiest session of KEMU, when all the societies become alive with vigour. While Ayesha Sikandar made her mark in the world of oratory, Zara Naveed broke into the literary scenario by winning all writing competitions. The 1st year dramatic society which is self-proclaimed as “komplein” also made its presence known by shooting 3 videos for the KAPS video competition. However the biggest success story of the year was the Bake Sale donation campaign held by SPWS. 1st year gave new meaning to this event by celebrating Ma’am Attiya’s birthday amid beautifully decorated lemonade and Gola stalls on cartwheels. Under the supervision of Humaira Sarfraz and Ammar Afzal, 1st year raised more than 80 grand and won the class trophy as well! Furthermore, some brilliant students from 1st year also participated in the National Science Olympiad held in LUMS aka Psi Fi ’10. They won laurels for KE by getting 3rd position in Diagnosis Dilemma and being the top 5 finalists in Tour de mind. The latter was a compulsory round for all the 200 or so teams from all over Pakistan. The competition was tough but we didn’t give up. Because we believe in Alta pete: Aim high!