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Tim Bowers, paralyzed 32-year-old outdoorsman, chooses to end life support

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IN Man Chooses to End Life Support After Being Paralyzed



INDIANAPOLIS (AP) - Tim Bowers got to decide for himself whether he wanted to live or die.

When the avid outdoorsman was badly hurt Saturday in a hunting accident, doctors said he would be paralyzed and could be on a ventilator for life. His family had a unique request: Could he be brought out of sedation to hear his prognosis and decide what he wanted to do?

Doctors said yes, and Bowers chose to take no extra measures to stay alive. He died Sunday, hours after his breathing tube was removed.

"We just asked him, 'Do you want this?' And he shook his head emphatically no," his sister, Jenny Shultz, said of her brother, who was often found hunting, camping or helping his father on his northeastern Indiana farm.

The 32-year-old was deer hunting when he fell 16 feet from a tree and suffered a severe spinal injury that paralyzed him from the shoulders down. Doctors thought he might never breathe on his own again.

Courts have long upheld the rights of patients to refuse life support. But Bowers' case was unusual because it's often family members or surrogates, not the patient, who make end-of-life decisions.

Medical ethicists say it's rare for someone to decide on the spot to be removed from life support, especially so soon after an injury. But standard medical practice is to grant more autonomy to patients.

The heart-wrenching call to remove life support is more often left to relatives. Even when a patient has outlined his wishes for end-of-life care, the decision can tear families apart.

Injured Hunter's Choice

Shultz, an intensive care nurse in Las Vegas, has seen it happen in her job. But her medical training also meant she understood the severity of her brother's injuries. His C3, C4 and C5 vertebrae were crushed.

Though his brain was not injured, his body was irreparably broken. Surgery could fuse the vertebrae, but that would only allow Bowers to sit up. He would never walk or hold his baby. He might live the rest of his life in a rehabilitation hospital, relying on a machine to help him breathe.

Shultz said her brother - the youngest of four siblings - wanted to talk but couldn't because the ventilator tube was still in place. If the tube were removed, she told him, doctors were not sure how long he would live. But when she asked if he wanted the tube reinserted if he struggled, Bowers shook his head no.

Doctors asked Bowers the same questions and got the same responses. Then they removed the tube.

The last five hours of Bowers' life were spent with family and friends, about 75 of whom gathered in the hospital waiting room. They prayed and sang songs.

Through it all, Shultz said, her brother never wavered in his decision to die.

"I just remember him saying so many times that he loved us all and that he lived a great life," she said. "At one point, he was saying, 'I'm ready. I'm ready.'"

Patients often change their minds after they have had time to meet with spiritual advisers and family, said Art Caplan, director of the medical ethics program at New York University's Langone Medical Center in New York City.

Dr. Paul Helft, director of the Charles Warren Fairbanks Center for Medical Ethics in Indianapolis, said cases in which the patient makes the decision usually involve a debilitating illness such as Lou Gehrig's disease, which compromises the body but leaves the mind intact.

"We give patients autonomy to make all kinds of decisions about themselves," he said. "We've recognized that it's important that patients have the right to self-determination."

Shultz said her family had an idea what her brother would want because he had previously talked with his wife, Abbey, whom he married Aug. 3, about never wanting to spend his life in a wheelchair.

She knows that not everyone would make the same decision. But she's thankful her brother was able to choose for himself.

"No outcome was ever going to be the one that we really want," she said. "But I felt that he did it on his terms in the end."

___

Associated Press writer Tom Murphy contributed to this story.

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kimcrdr November 06 2013 at 5:55 PM

Ok this made me cry, I'm glad he got to choose for himself though, may he RIP, prayers going out to his family and friends!!!

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harleysugar47 November 06 2013 at 4:26 PM

In May 2000 after a head on wreck car/motorcycle...my husband lay brain dead in ICU for 8 days. I was the only one besides his family that could turn him off but i had head injuries and didn't get my right mind till then. Of course his family had other ideas. I hope I get the chance to decide for myself as this man did. Having a living will can be contested by next of kin. My sympathies for he and his family. By the way..the jokes are in very poor taste and disrespectful. May you never be in their shoes.

Flag Reply +8 rate up
Hi Pinga-Pinga!! November 06 2013 at 11:18 PM

TIM BOWERS, the injured man, was 32 years old. He was an outdoorsman and obviously lived an extremely active life. If he chose to continue living 'as-is' he would be dependent on others to change his diapers for the rest of his life. That alone would be profoundly degrading plus I'm sure he didn't want to have anything to do with the pity others would forevermore have for him.

I cared for my terminally ill Mother at home whose diagnosis was severe dementia and failure to thrive. Her doctors strongly advised that I put her in a nursing home but I knew, if I did, that she'd be dead in less than 2 months.

Mom slept in a hospital bed in my dining room and I slept on the sofa in the living room. I got up every 2 hours, day in and day out, 24-hours a day, to change her diapers and rotate her position so she wouldn't get bedsores. It was unbelievably grueling but I'd been blessed with the most loving, Christian parents and I felt that eventually it simply became My Turn.

But Mom never would have chosen what I was put through in caring for her and my determination to keep her alive. I had almost no life whatsoever for more than 3 years (those were the last of 15 years Mom lived with me), I went through all my savings, everything imaginable went on the back burner because it cost me $1200 to $1500 monthly for supplies to keep Mom alive...things like urgently needing a new roof because mine leaks, foregoing critical dental work and car maintainance/repairs, cutting drastically back on the food budget and so much more.

I don't regret it and wish I could have just one more week with Mom here again. But the truth is that I'd never, ever, EVER want my kids to have to do for me that I've done for my Mother. And I'd never want to deplete them emotionally, physically and financially.

Another way to look at it is...if God wanted him to keep living he would have made it happen. Period.

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deb3318 November 06 2013 at 11:19 PM

How cruel to have to struggle to breath for hours before one dies. Why not give him an overdose of a drug in cases like this. We had to disconnect my mother from a ventilator and it tooks hours of horrible struggling trying to breath on her own until her heart gave out.

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2 replies
tdjunior99 deb3318 November 06 2013 at 11:25 PM

i agree, horrible way, like being choked to death..but, life can be cruel..

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Annabelle deb3318 November 06 2013 at 11:44 PM

How do you know that he struggled to breathe; this does not necessarily happen at the end of life. And your mothers' case is not the norm; and what do you mean, you "had to disconnect your mother from the ventilator? Your comment doesn't ring true.

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jwlryangel November 06 2013 at 11:22 PM

I believe God DID have the last say in this decision. Without life support, nature takes it's course unless God miraculously intervenes. It does happen, but more often than not...does not happen. I respect the family in putting their feelings and desires aside and supporting this young man in his own final choice. A difficult task for all involved...the patient and the family. My condolences.

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1 reply
powermetal2000 jwlryangel November 06 2013 at 11:31 PM

The same god that made him fall & suffer in the first place?

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1 reply
powermetal2000 powermetal2000 November 06 2013 at 11:31 PM

Darn, double post

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Bernice November 06 2013 at 4:13 PM

I never want to live on a ventilator for life, that is why there is a thing called a Living Will....to each its own. God Bless

Flag Reply +7 rate up
iricd November 06 2013 at 4:12 PM

We had to make this same decision for my dad nine years ago tomorrow. It was very hard indeed but it was one of hte most selfless decision we can make. We didn't want him to go, but we didn't want him to suffer. May God be with you.

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harryc922 November 06 2013 at 11:28 PM

lots of faith and guts

Flag Reply +4 rate up
lettyswe November 06 2013 at 4:08 PM

To make a life or death decision never comes easy.. it's better if the person is able/capable to decide him/herself. As an RN and a soon to be doctor I will encounter many situations similar to the one being discussed. I believe that everyone deserves to chose how they want to go about. Their decision to end their own lives has to do with the quality of life from that moment on. It's quality vs quantity. It should not be about what the family thinks or wants or about the financial or emotional "burden". And last but not least : what I learned in one of my nursing classes (" Nursing at the end of life") was that death should be perceived as a continuity of one's life, it's about remembering all the nice things that the dying person offered and left behind , things that had an impact in our lives..

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Puppino November 06 2013 at 11:33 PM

I would have wanted the same thing,, Its tuff but know way to live for sure I would like a nice shot put me to sleep

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