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Wesley J. Smith: Should Courts or Ethics Committees Decide “Futile” Care Cases?
First Things/Secondhand Smoke ^ | 8/19/10 | Wesley J. Smith

Posted on 08/21/2010 1:13:18 PM PDT by wagglebee

Longtime readers of SHS and those who have read my books and other writings, know I oppose legalizing futile care theory. Futile care theory would permit bioethics committees or doctors to refuse wanted life-sustaining treatment based on quality of life and/or resource husbanding purposes (as opposed to being physiologically useless).

The bioethicist Art Caplan weighs in on the matter in an opinion piece in the Philadelphia Inquirer. From the column “Who Should Decide When Care is Futile?”:

The court [in dismissing a moot futile care litigation] did, nevertheless, understand the importance of the matter, saying: “The issues presented are profound and universal in application. They warrant thoughtful study and debate not in the context of overheated rhetoric in the battlefield of active litigation, such as marked the [Terri] Schiavo debate, but in thoughtful consideration by the Legislature as well as executive agencies and commissions charged with developing the policies that impact on the lives of all.”

State legislatures, bioethics commissions, religious groups, think tanks, and the federal government would do well to heed those words. Although few cases involving medical futility reach court, that doesn’t mean doctors don’t grapple with them regularly in hospitals and intensive care units. Although nearly every such case is resolved in favor of continuing care, that doesn’t mean this is the best use of medical resources or public money. And although this nation is likely to encounter more cases like Ruben Betancourt’s, that doesn’t mean we should resolve them all in the courts.  What these facts do mean is that it’s time to openly and publicly examine what should happen when medical professionals feel they can do no more for patients, but their families, partners, and friends vehemently disagree.

We do need to grapple with these issues, primarily through education, not coercion.

Indeed, the last thing we need is for faceless bioethics committees to be legally empowered to decide behind closed doors to withdraw care that is working by keeping the patient alive–based on a subjective belief that the patient’s life is not worth living–as now allowed in Texas.  That kind of power requires significant check and balances, such as the right of cross examination, a public record, an open and discoverable  deliberative process, explicitly stated bases for decisions, and the right to appeal.  This doesn’t mean the process needs to start in courts, but it sure is where disputes that cannot otherwise by resolved, should end up.

Moreover, those who wish to cut off treatment based on quality of  life, should bear the significant burden of proof that continuing care is not in the best interests of the patient or what the patient wanted as expressed in an advance directive.  Otherwise, the overarching purpose of medicine–extending life when that is what the patient wants–could be profoundly undermined.

Illustrating the danger, in Culture of Death, I recounted the Baby Ryan case, in which doctors wanted to unilaterally refuse dialysis based on their view that the baby had zero chance of surviving kidney failure.  They were wrong.  The boy was eventually weaned off dialysis and lived for several years, during which time he was a happy child, the apple of his parents’ eyes.)



TOPICS: Health/Medicine; Politics
KEYWORDS: futilecarelaws; moralabsolutes; prolife
Indeed, the last thing we need is for faceless bioethics committees to be legally empowered to decide behind closed doors to withdraw care that is working by keeping the patient alive–based on a subjective belief that the patient’s life is not worth living–as now allowed in Texas.

Yet this is EXACTLY what Zero and the culture of death wants to implement with Obamacare.

1 posted on 08/21/2010 1:13:24 PM PDT by wagglebee
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To: cgk; Coleus; cpforlife.org; narses; Salvation; 8mmMauser

Pro-Life Ping


2 posted on 08/21/2010 1:14:29 PM PDT by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: BykrBayb; floriduh voter; Lesforlife

Ping


3 posted on 08/21/2010 1:15:00 PM PDT by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: 185JHP; 230FMJ; Albion Wilde; Aleighanne; Alexander Rubin; An American In Dairyland; Antoninus; ...
Moral Absolutes Ping!

Freepmail wagglebee to subscribe or unsubscribe from the moral absolutes ping list.

FreeRepublic moral absolutes keyword search
[ Add keyword moral absolutes to flag FR articles to this ping list ]


4 posted on 08/21/2010 1:15:40 PM PDT by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: wagglebee

You mean “Death Panels” just like Governor Sarah Palin predicted? I thought the media “debunked” that months ago?


5 posted on 08/21/2010 1:17:22 PM PDT by 2ndDivisionVet (I don't need a newspaper to know the world's been shaved by a drunken barber.)
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To: wagglebee

Any society that has no problem murdering its babies will have no problem nurdering its elder citizens.


6 posted on 08/21/2010 1:18:52 PM PDT by Americanexpat
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bump!


7 posted on 08/21/2010 1:22:23 PM PDT by trisham (Zen is not easy. It takes effort to attain nothingness. And then what do you have? Bupkis.)
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To: 2ndDivisionVet

Exactly. I heard a guy on radio the other day discussing a case where a family wanted to continue care and Doctors refused saying he is brain dead, and Docs went to court. The guy’s point was we need a (death) panel because courts are too messy, are cumbersome and take too much time. I say leave it with the family, and if need be hash it out in “open” court with family being involved. Better than a secret panel going down their charts of protocols and guidelines and determining that patient is on borrowed time anyway and would be better useful as soylent green. No death panels!


8 posted on 08/21/2010 1:24:23 PM PDT by shalom aleichem
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To: Americanexpat
From across The Pond, 2008....

Baroness Warnock: Dementia sufferers may have a 'duty to die'

9 posted on 08/21/2010 1:31:57 PM PDT by mewzilla (Still voteless in NY-29. Over 400 roll call votes missed and counting...)
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To: mewzilla

Baroness Warlock is truly evil!


10 posted on 08/21/2010 1:33:49 PM PDT by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: shalom aleichem

Only in an environment where government has absolutely no control over delivery of services will it be possible to guarantee adequate medical services.


11 posted on 08/21/2010 1:40:18 PM PDT by Louis Foxwell (They are the vultures of Dark Crystal screeeching their hatred and fear into the void ....)
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To: wagglebee
This is in a Brit paper today....

'We'll do cancer scan on Monday... if she's still alive': Agony of family of dying grandmother who devoted her life to NHS

12 posted on 08/21/2010 1:41:29 PM PDT by mewzilla (Still voteless in NY-29. Over 400 roll call votes missed and counting...)
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To: Amos the Prophet

Absolutely. Government having any say certainly infringes on guarantee of “life” liberty and pursuit of happiness, but as new Justice Kagan says, those nice words are not in the Constitution but only in the Declaration of Independence (which she and Obama do not regard as “law” and Algore would not consider as “controlling legal authority” but it might rate as a 3rd Chakra). The 14th amendment allows government to take your life, liberty or property with “due process of law” (i.e. Obamacare w/Death Panels)


13 posted on 08/21/2010 1:54:10 PM PDT by shalom aleichem
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To: shalom aleichem
The issue is a phoney one. Either you subscribe to the concept that innocent life is sacred, or you don't. If you don't, then there is no logical stopping point. The elderly are next, followed by the retarded, the chronically insane, and other "useless eaters," to quote a famous "bioethicist."

Ask the Germans. They went through this song and dance already, back in the thirties and forties.

14 posted on 08/21/2010 1:59:09 PM PDT by hinckley buzzard
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To: wagglebee

“”Should Courts or Ethics Committees Decide “Futile” Care Cases?”

Neither. Patients (and their families) and doctors should make that decision.


15 posted on 08/21/2010 2:25:49 PM PDT by SumProVita (Cogito, ergo...Sum Pro Vita. (Modified Decartes))
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To: hinckley buzzard

Our own Supreme Court declared that ridding undesirables from society as A-OK (Buck v Bell, 1927 -
http://en.wikipedia.org/wiki/Buck_v._Bell )

but since that came down around the time of Hitler’s crap, it was not followed up on, until... Bambi’s Brave New World! (Buzzy Ginsberg recently said something about Roe v Wade was designed to rid us of undesirables. I think she asked, Wasn’t that what that (Roe) was all about? Geesh!). Here is an article on that:
http://newsbusters.org/blogs/tom-blumer/2009/07/09/whiff-euthanasia-ginsburg-tells-nyt-roe-was-about-populations-we-dont-wa


16 posted on 08/21/2010 2:27:26 PM PDT by shalom aleichem
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