Thursday, 19 September 2019
Euthanasia and Futile Care :: Euthanasia Physician Assisted Suicide
Euthanasia and "Futile Care" Imagine visiting your 85-year-old mother in the hospital after she has a debilitating stroke. You find out that, in order to survive, she requires a feeding tube and antibiotics to fight an infection. She once told you that no matter what happened, she wants to live. But the doctor refuses further life-sustaining treatment. When you ask why, you are told, in effect, "The time has come for your mother to die. All we will provide is comfort care." Sound far-fetched? It's not. It's already happening. Just as doctors once hooked people up to machines against their will, now many bioethicists advocate that doctors be permitted to refuse life-sustaining treatment that a patient wants but that they deem "futile" or "inappropriate." Alarmingly, hospitals in California and throughout the country have begun to implement these "futile-care" policies that state, in effect: "We reserve the right to refuse service." Medical and bioethics journals for several years kept up a drumbeat advocating the implementation of medical futility policies that hospitals -- for obvious reasons -- don't publicize. The mainstream news media have generally ignored the threat. As a consequence, members of the public and their elected representatives remain in the dark as "futilitarians" become empowered to hand down unilateral death sentences. Indeed, futile-care policies are implemented so quietly that no one knows their extent. No one has made a systematic study of how many patients' lives have been lost or whether futile-care decisions were reached according to hospital policies or the law. The idea behind futile care goes like this: The patient wants life- sustaining treatment; the physician does not believe the quality of the patient's life justifies the costs to the health institution or the physical and emotional burdens of care; therefore, the doctor is entitled to refuse further treatment (other than comfort care) as "futile" or "inappropriate." Treatments withheld under this policy might include antibiotics to treat infection, medicines for fever reduction, tube feeding and hydration, kidney dialysis or ventilator support. Of course, physicians have never been -- nor should they be -- required to provide medical interventions that provide no medical benefit. For example, if a patient demands chemotherapy to treat an ulcer, the physician should refuse. Such a "treatment" would have no medical benefit. But this kind of "physiological futility," as it is sometimes called, is not what modern futile-care theory is all about.