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Wesley J. Smith: Futile Care Theory: The Dangers of Rushing to End Treatment
First Things/Secondhand Smoke ^ | 5/14/11 | Wesley J. Smith

Posted on 05/14/2011 10:42:04 AM PDT by wagglebee

An Australian “brain dead” woman (clearly a misnomer, about which more below) was ordered removed from life support only a few weeks after suffering brain injury.  But thanks to the efforts of her family, she is now recovering.  From the story:

A TERRITORIAN has woken from the dead. Gloria Cruz was diagnosed as being “brain dead” by a team of doctors after suffering a massive stroke. But her distraught husband Tani begged them not to switch off her ventilator. “I’m a Catholic – I believe in miracles,” he told them…

Ms Cruz had a stroke in her sleep on March 7 and was rushed to Royal Darwin Hospital. After a CAT scan, a doctor said she probably had a brain tumour. Mr Cruz, 51, who works as a forecaster at the Darwin Met Bureau, said: “The doctor didn’t elaborate. He just said I should prepare myself.” His wife underwent brain surgery immediately…Doctors said the case was “hopeless” and she would probably die within 48 hours.

When a doctor recommended that the ventilator be removed and Mrs Cruz be allowed to die, her husband told them: “A miracle could still happen. I told him that God knows how much I love her – that I don’t want her to suffer but I don’t want her to leave us.” Mr Cruz asked for a 48-hour respite. A doctor, social worker and patient advocate later rang him and again asked him to agree to have the ventilator turned off. After two weeks, a breathing tube was inserted in Mrs Cruz’s mouth and the ventilator was turn off. Hospital staff were stunned when she woke from her coma three days later.

This story illustrates many of the problems we see in medicine today:
1. There is a tendency to give up way too early on patients who have serious brain trauma.  I think that is in part to the bioethical meme that rejects human exceptionalism, accepts the so-called “quality of life” ethic that presumes people with catastrophic cognitive traumas have lower moral worth, and indeed as some hold, are mere human “non persons.”
2. “Brain death” is a badly misused term. If Cruz breathed on her own after the ventilator was turned off, by definition, she wasn’t dead, but in a coma, as the story stated later.  Media and medical communicators have to watch their lexicon.  An unconscious patient is a living patient.
3. Diagnosis of persistent consciousness can’t usually be done reliably in days, or even weeks.  It takes months, and even then, there is a 40% misdiagnosis rate.  It would appear that a hasty prognosis might have been made in this case that could have had tragic results.  What if the family hadn’t fought for her life?  She might not have recovered to the point that she was able to breathe unassisted.
4. Doctors should not have the unchecked power to unilaterally “pull the plug.” Decisions that wanted further treatment is “futile” should not be made by the doctors or hospital bioethicists or social workers.  Rather, they require strong checks and balances and decision by rule of law.  If the wanted treatment is clearly so burdensome to the patient (not the medical team or hospital finances) that it should be stopped, that is a decision to be made in open courts with rights of cross examination and appeal.
5. Occasionally, “miracles” do happen.

This part of the story raised my eyebrow:

A doctor was so amazed, he said: “It’s a miracle.” And then he turned to Mr Cruz and said: “I am happy that my prognosis was wrong.”

Well, that’s nice.  But I hope the doctor learned something from this experience.  Sometimes prognoses are wrong.  The one in one hundred chance comes up one in one hundred times.  Hope should not be too quickly abandoned.



TOPICS: Health/Medicine
KEYWORDS: deathpanels; futilecare; moralabsolutes; prolife
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To: BykrBayb

As they say apples and oranges


21 posted on 05/14/2011 12:11:19 PM PDT by montanajoe
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To: utherdoul

The insurance companies write the policies themselves. If they can’t afford to provide the service they’re selling, we should not kill their customers to make the insurance companies solvent.


22 posted on 05/14/2011 12:12:12 PM PDT by BykrBayb (Somewhere, my flower is there. ~ Þ)
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To: montanajoe

What the difference? Why do you think it’s okay to kill disabled people and people with terminal conditions, but not healthy people? What makes the healthy people more deserving of humane treatment?


23 posted on 05/14/2011 12:14:11 PM PDT by BykrBayb (Somewhere, my flower is there. ~ Þ)
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To: utherdoul; Dr. Brian Kopp; trisham; DJ MacWoW; little jeremiah; Coleus; narses; Lesforlife; ...
We have to face the cold hard fact that there isn’t enough money in the insurance industry or in the government to keep every person alive. The best thing to do if a person cannot pay for care and is unlikely to recover is to make sure the death is quick and dignified.

So, you not only support death panels you also support euthanizing people?

If god wants the person to pull through they will one way or the other.

First of all God is spelled with a capital G, those who believe in Him rarely make the mistake that you did twice in your post.

Secondly, God has given us medical knowledge.

No sane person would want his corpse to be kept warm to kill another individual who has a chance at life.

Now you seem to be a "duty to die" regardless of financial ability, is that correct?

As stated if the individual can pay for his own bed through family or personal savings then there isn’t a problem.

Why? You just declared that a "sane person" would want to die.

24 posted on 05/14/2011 12:15:25 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

I replied to the premise of the article. YOU made an assumption based entirely on something I did not say and you expect me to defend your wild off topic assumption.


25 posted on 05/14/2011 12:21:59 PM PDT by montanajoe
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To: BykrBayb

I replied to the premise of the article. YOU made an assumption based entirely on something I did not say and you expect me to defend your wild off topic assumption.


26 posted on 05/14/2011 12:22:03 PM PDT by montanajoe
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To: montanajoe

You took the position that the person or entity that pays the bills is entitled to decide who lives and who dies. I inquired if you extend that to all people, or just the disabled and dying. You indicated there is a difference. Please explain what that difference is. What makes healthy people more deserving of humane treatment than disabled and dying people?


27 posted on 05/14/2011 12:29:20 PM PDT by BykrBayb (Somewhere, my flower is there. ~ Þ)
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To: BykrBayb
I'm not saying anyone is entitled to decide who lives or dies I my view only God does that and there is nothing anyone can do to change that.

I am pointing out in response to the OP the fact that if the person or or their family cant pay for the care then a insurance company or government bureaucrat is going to decide.

That's the system like it or not...

28 posted on 05/14/2011 12:42:53 PM PDT by montanajoe
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To: BykrBayb
I'm not saying anyone is entitled to decide who lives or dies I my view only God does that and there is nothing anyone can do to change that.

I am pointing out in response to the OP the fact that if the person or or their family cant pay for the care then a insurance company or government bureaucrat is going to decide.

That's the system like it or not...

29 posted on 05/14/2011 12:43:03 PM PDT by montanajoe
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To: montanajoe

Why should they be allowed to decide not to fulfill the terms of the contract they wrote and entered into, resulting in the killing of the other party to the contract? What is it about the condition of the other party to the contract that you find makes the contract non-binding on the part of the insurance companies? What is the point in paying insurance premiums if the simple act of turning in a claim voids the contract?


30 posted on 05/14/2011 12:52:51 PM PDT by BykrBayb (Somewhere, my flower is there. ~ Þ)
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To: montanajoe; wagglebee

Decide what? Is that like a woman’s right to choose, where you never specify what she’s choosing? Say what you mean, without euphemisms or vague references to choice. What you are advocating is the death panels’ right to decide who lives and who dies by denying humane treatment to those who need it, even after they’ve already paid for it.


31 posted on 05/14/2011 12:59:27 PM PDT by BykrBayb (Somewhere, my flower is there. ~ Þ)
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To: BykrBayb
Obviously you have been fortunate enough to have never had a major illness of accident. Insurance companies exist to benefit their shareholders not their policyholders. I had a major claim and I was laughed at by the claims representatives when I made your exact arguments..
32 posted on 05/14/2011 1:06:27 PM PDT by montanajoe
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To: BykrBayb
I'm not advocating anything I'm simply stating a fact.
33 posted on 05/14/2011 1:09:53 PM PDT by montanajoe
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To: montanajoe
Obviously you have been fortunate enough to have never had a major illness of accident.

Obviously. If I had, then of course I would agree that the insurance company should have turned down my claim and had me euthanized.

34 posted on 05/14/2011 1:41:03 PM PDT by BykrBayb (Somewhere, my flower is there. ~ Þ)
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To: montanajoe

There’s another factor at play.

There is a continuum of care between hooked up to all the bells and whistles, and starving/thirsting/medicating to death.


35 posted on 05/14/2011 2:05:02 PM PDT by little jeremiah (Courage is not simply one of the virtues, but the form of every virtue at the testing point. CSLewis)
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To: All
Pinged from Terri Dailies


36 posted on 05/15/2011 10:56:24 AM PDT by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: wagglebee

Wesley J Smith is an Orthodox Christian!

http://www.aoiusa.org/blog/2009/04/wesley-j-smith-orthodox-advocate-for-human-“exceptionalism”/


37 posted on 06/02/2011 8:46:02 PM PDT by Honorary Serb (Kosovo is Serbia! Free Srpska! Abolish ICTY!)
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