“Ah yes,” Horton said, glad to be off the previous argument. He put an image up on the screens. “Currently we have a prototype human-sized stazer that stands ready for us to use after animal studies are done and we’re ready to move on to IRB approved human studies, presumably randomizing critical patients in whom stasis is either used or not used while trying to keep them alive. Here’s my ethical question. We have a device that apparently does no harm. We get in a patient who’s dying and for whom we don’t have treatment available at the moment, be that blood or the availability of an appropriate medical professional, or we’re out of a critical drug, or an organ transplant. When the alternative’s death, is it ethical not to use our stazer to temporize until we can treat the patient? Even if the stazer has some unrecognized untoward effect, should we not use it to save the patient at present? After all, x-rays do have untoward effects, but we hardly hesitate to use them to help patients. Say we find someday that, like x-rays, stasis increases your eventual risk of cancer, isn’t it our ethical duty to take that risk for a patient who’s dying now?”
They seemed rocked back by the question. One of the committee members asked for concrete examples of the kinds of conditions Horton thought stasis could be used to save lives in.
He described how he thought it could save lives endangered by massive blood loss—by letting doctors put the resuscitation on hold until type-specific blood was available rather than proceeding with somewhat risky “universal donor” blood. And continuing to hold the patient in stasis until he or she was in the operating room with a team ready to transfuse that blood while also operating to stop the bleeding.
How it could be used to limit damage during a stroke, heart attack, vascular injuries, and traumatic amputations.
He kept going through other conditions he’d thought of until the chairwoman said, “Okay, okay. I think we get it. There are a lot of conditions for which the ability to take a pause might save life or limb. I think it comes down to the risk versus the benefit. Is the unknown, possibly nonexistent, risk of stasis something that should keep us from using this modality to attempt to save people on the verge of death?”
There was a little more debate, but in the long run, they unanimously decided that, ethically, the treating physician should use the stazer to arrest inexorable progress toward the loss of life or limb if it seemed likely that such a pause to allow recruitment of resources might allow salvage of a dire situation.
Then Gerald posed one more question, “We’ve been planning to seek IRB (Institutional Review Board) approval to randomize critical patients to the use of the stazer versus standard treatment without stasis. I’m more and more feeling that such a study would be unethical as well. I can see the day that someone’s family might sue us because we didn’t staze their loved one, study or not. I think animal studies must be done, but human studies shouldn’t.”
This brought some widening of the eyes, but eventually they unanimously agreed that such a study would be unethical and shouldn’t be carried out.
Dr. Miles promised to write up their decision so Horton would have its substance to use in his grant application process.
And, incidentally, in defending himself should he decide to staze someone and later encounter objections.
And, I can forward a copy to the chairman of the emergency department with a request that we be allowed to keep the stazer physically in the ED in case of its need, Horton thought as he walked back to his office. And I should try to get on the agenda to give another talk to the staff in case someone else has a case where they want to use it.
***
Grace glanced across the front seat of the truck at Gunnar. A young man named Albrecht sat between them, someone Gunnar had introduced as a newly hired bioengineer.
Albrecht was new enough that he’d been surprised by how slippery Simone’s Stade was when they were loading it into the back of Gunnar’s truck. The back of the truck also held the Mylar wrap for Simone’s Stade and the stazing equipment.
“Gunnar,” she asked, “do you think we’re going to have trouble with people wanting to know just what the hell we think we’re doing when we try to take Simone’s Stade into the oncology center?
“Sure,” he said. “Why would it suddenly get easy now? I hope you have Dr. Jonas on speed dial? We may need him to run interference for us.”
“Yeah,” she sighed. “And his nurse and his fellow. I’m worried. They had to squeeze her into a fully booked session today. What if they don’t have time to properly take care of her? I tried to impress on them how sick she was when she got stazed, but I’m not sure they believed me.”
Gunnar snorted. “I was there. I believe you. We brought a stazing bag for her. We’re going to lay it out on her treatment chair. As soon as she’s destazed we’ll put her on it. If she crashes, we’ll just zip it up and restaze her until they can do this in the hospital with a crash cart standing by.”
“Oh, God. I hope it isn’t that bad!”
Gunnar had a grim look on his face, “Better to be over rather than under-prepared.”
The truck had pulled up to the entrance of the oncology center. They all got out and went around to the back of the truck.
Gunnar lowered the tailgate, then he and Albrecht slid Simone to the back edge and grabbed the handles of her Stade. Gunnar gave a count of three
