Tim Bowers: tragic accident raises serious questions about the limits of autonomy

Tim Bowers, newly married with his wife expecting their first child had a tragic fall while hunting that rendered him a quadriplegic.  His family pressed doctors to bring him out of his medically induced coma only one day after the accident to ask him if he wanted to continue living. He chose not to have the breathing tube replaced and died hours later.
 
The Daily Mail chronicles the events of that day:

Confronted with the devastating prognosis, Bowers' family asked doctors at Fort Wayne's Lutheran Hospital a hard question: Could Bowers be brought out of sedation so he could be told of his condition and decide for himself whether he wanted to live or die? The doctors said yes.

Tim - who has a step son - previously talked with his wife, Abbey, who he married on August 3, about never wanting to spend his life in a wheelchair, so his family knew which way it was likely to go, though it meant never seeing his unborn child. 
His sister - one of three - has seen this situation 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. He'd never return to those outdoor activities that gave him such peace.

'We just asked him, do you want this? And he shook his head emphatically no,' Jenny Shultz said.

These events create serious questions about the ethics of applying autonomy in these circumstances as well as the wisdom of posing such a grave question as: do you want to die? to a person so recently traumatized.
 
Editor of the disability website, New Mobility, Tim Gilmer, posed the begging question: How could Tim Bowers truly understand what might lie ahead for him just minutes after being aroused from a sedated state?
 
Just as it is difficult to imagine what life would be like with a severe Spinal Cord Injury, the decision to allow Bowers to be made conscious and to pose the ultimate question in these circumstances is deeply disturbing. Gilmer goes on:
 

True, his sister, a nurse, had seen quads in ICU, but had she ever visited a rehab hospital or gotten to know quads of a similar level as her brother who had gone on to live fulfilling lives? It's understandable that his sister and family wanted what they thought was best for him, but was anyone in the family, most of all Bowers himself, competent to truly know his potential as a quad?

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?

Another New Mobility contributor, Bob Vogel added to the debate:

Although with a severe SCI, recovery is highly unlikely, it does happen. I have a friend who crushed his C4-6 vertebrae in an accident and was told he was a complete C4 quad. Against all odds, two weeks later, the swelling in his spinal cord and spinal shock went away, and he woke up with complete sensation and movement.

Did the doctors provide the Bowers 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?

The article doesn't explain why Bowers