Mandela’s family may face quandary over end of life
‘I’m less anxious than I was a week ago,’ Graca Machel tells Johannesburg radio
Graca Machel, wife of former South African president Nelson Mandela, says his condition has improved in recent days. Photograph: Getty Images
Nelson Mandela’s wife, Graca Machel, said the condition of the hospitalized former South African president has improved over the last week.
Mandela (94), who has been in the hospital in Pretoria, the country’s capital, since June 8th “is responding to treatment,” she said in an interview with Johannesburg’s SAFM Radio.
“I’m less anxious than I was a week ago,” she said.
Mr Mandela’s family might in the days or weeks to come face the same awful decision that has confronted numerous other families in an age of life-sustaining miracle machines - when is it time to say “enough”.
Medical experts in and outside South Africa who are not involved in the former president’s care have taken the government’s cryptic statement - that Mandela is in “critical but stable condition” - to mean that he is being sustained by equipment, which, given his advanced age, could present his relatives, doctors and the country with a wrenching choice about how long to keep the 94-year-old alive.
Any decision would be made in the glare of an international spotlight and would involve an extended family that has shown itself to be fractious about decisions regarding inheritance, his eventual burial location and his legacy. And it would do so under a set of South African laws and court precedents that leave some unnerving gray areas over who might make the ultimate decision.
In cases where the patient has left a living will or has appointed a surrogate to act on his behalf, the path is clear. But in the absence of a living will, or if no surrogate has been chosen or there is more than one surrogate - like siblings or a sprawling extended family like the one Mandela has - South Africa’s law is not entirely clear, legal experts here say.
“It is not easy when you are confronted with the internal wrangling within the family that has spilled into the public domain,” said Nomboniso Gasa, a political and cultural analyst in Johannesburg. “Still, despite all the contention and all the fights the Mandelas seem to be having, I think they are quite aware that an end-of-life decision may need to be taken. But the high profile makes it so very difficult.”
This, too, is an age when ventilators, feeding tubes and other high-tech machines can keep people - even those in a permanent vegetative state - alive for months and even years, as in the case of Ariel Sharon, the 84-year-old former Israeli prime minister who has been in a coma since he had a devastating stroke in 2006.
Not enough is known about Mandela’s medical condition to know exactly how his case might fall under South African law, experts in medical legal issues say. A court affidavit filed in June in a dispute within the family over where Mandela might be buried claimed that he was in a permanent vegetative state, but both family and medical team members have since denied this.