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Who Will Decide When You Should Die?
The Village Voice ^ | Dec 1 2003 | Nat Hentoff

Posted on 12/01/2003 12:55:41 PM PST by wisconsinconservative

Nat Hentoff The Culture of Death Who Will Decide When You Should Die? December 1st, 2003 1:00 PM

Ironically, the "right to die" movement was founded on the premise that patients and/or families are the best judges of when it is time to die. Now, however, we are being told that doctors and/or ethicists are really the best judges of when we should die. —Nancy Valko, journalist, medical ethicist, and intensive care unit nurse, "Bioethics Watch," Voices, 2003

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Bob Schindler [father of Terri Schiavo] poignantly observes, "We pay great lip service in this country to disability rights, but as the degree of a person's disability increases, the level of legal protection that person receives decreases." —Nancy Valko, lifeissues.net, August 2003

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In a November 4, 2002, story in The Philadelphia Inquirer, "Penn Hospital to Limit Its Care in Futile Cases," Stacey Burling reported that the ethics committee of the University of Pennsylvania Hospital had approved new guidelines which stated, "intensive care would not routinely be given to patients in a persistent vegetative or minimally conscious state. Only patients who had explicitly requested such care would get it." This exclusion from rehabilitative or other forms of life-enhancing treatment will apply to "patients with severe brain damage."

These patients, for whom the hospital and its ethics committee have abandoned hope, would not even be admitted to an ICU (intensive care unit).

In David Caruso's Associated Press report (December 12, 2002) on this last mile for patients at the University of Pennsylvania Hospital, he quoted Stephen Gold, a lawyer in Philadelphia who specializes in representing people with disabilities.

Noting this discounting of the lives of patients who cannot speak for themselves and have not written advance directives, Gold said that the University of Pennsylvania Hospital, and other institutions that now have similar policies, might also consider cutting off intensive care for people without health insurance or who have other handicaps beyond present guidelines.

"It is a slippery slope they are going down," Gold continued. "If we have a way to provide a medical treatment for people that will keep them alive, we should always provide it, unless they have a living will saying we shouldn't."

Gold also told the Associated Press, "Not everyone agrees on what constitutes a life worth living. I had a client with cerebral palsy once who was asked to sign a do not resuscitate order [do not revive the patient]." But that patient had gone into the hospital "to be treated for appendicitis."

Wesley J. Smith, an expert on the growing culture of death that is being proposed and implemented by hospitals and bioethicists, makes the chilling point: "Now, a new medical hegemony is arising, one that proclaims the right to declare which of us have lives worth living and are therefore worth treating medically, and which of us do not.

"Unless people object strongly . . . to this duty to die . . . and legislatures take active steps to intervene, this new and deadly game of 'Doctor Knows Best' will be coming soon to a hospital near you."

Wes is one of the writers and researchers I consult on this nationwide movement to get the public to endorse legal euthanasia for those who would be "better off dead," as certain bioethicists say of patients for whom more treatment is "futile." I strongly recommend Smith's revised and updated Forced Exit (Spence Publishing Company, 111 Cole Street, Dallas, TX 75207; also available on amazon.com).

Another specialist in these life-or-death matters whom I have relied on for many years is Nancy Valko. She not only writes extensively and gives workshops on medical ethics, but actually also works full-time in the intensive care unit at a county hospital in St. Louis.

Among Valko's nursing specialties are oncology, kidney machines, trauma, cardiac and cancer care, and patients who may or may not be in a persistent vegetative state. Therefore, she is continually on the front line of the kinds of issues involved in Terri Schiavo's case, and the many more to come.

In an article ("Futility Policies and the Duty to Die," Voices, "Bioethics Watch," wf-f.org), she writes:

"This theory [that some lives are no longer worth living] has now evolved into 'futile care' policies at hospitals in Houston, Des Moines, California and many other areas. Even Catholic hospitals are now becoming involved. . . . Thus, the 'right to die' becomes the 'duty to die,' with futile care policies offering death as the only 'choice.' . . . A poor prognosis, which can be erroneous and is seldom precise, will become a death sentence."

I have debated bioethicists who are true believers in the "duty to die" when care is "futile." These exchanges have been on college campuses, radio, and television. When I bring up the history of "futile care" in pre-Hitler Germany (as I did in last week's column), the "duty to die" advocates become deeply offended. Nonetheless, they are sincerely continuing a lethal legacy.

Nancy Valko continues: "Just a generation ago, doctors and nurses were ethically prohibited from hastening or causing death. Family disputes and ethically gray situations occurred, but certain actions such as withdrawing medically assisted food and water from a severely brain-damaged but non-dying person were considered illegitimate no matter who was making the decision.

"But," Nancy Valko emphasizes, "with the rise of the modern bioethics movement, life is no longer assumed to have the intrinsic value it once did, and 'quality of life' has become the overriding consideration. Over time, the ethical question, 'what is right?' became 'who decides?—which now has devolved into 'what is legally allowed?' "

In the aforementioned November 4 Philadelphia Inquirer story, Stacey Burling reported what physicians and bioethicists consider a worrisome obstacle to expanding "what is legally allowed."

"Hospital leaders [around the country] fear they would lose a lawsuit if they denied care demanded by a family." These officials and bioethicists want more case law to enable them to end lives they consider "futile."

Until the media spend more space and care on who decides whether—and how—certain disabled Americans should die, I recommend your remembering that, as disability rights activists say, many of us are only temporarily able.


TOPICS: Editorial
KEYWORDS: schiavo; terri; terrischiavo; terrischindler; terrisfight
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1 posted on 12/01/2003 12:55:42 PM PST by wisconsinconservative
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To: biblewonk
(Ping.) What say you?
2 posted on 12/01/2003 12:58:27 PM PST by newgeezer (fundamentalist, regarding the Constitution AND the Holy Bible, i.e. words mean things!)
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To: sweetliberty; nickcarraway; T'wit; msmagoo; cyn; cpforlife.org; Ohioan from Florida
ping
3 posted on 12/01/2003 12:58:29 PM PST by wisconsinconservative ("The penalty good men pay for indifference to public affairs is to be ruled by evil men.")
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To: wisconsinconservative
Hentoff BTT. Nat has a habit of asking his smugly liberal readership some exquisitely uncomfortable quetions.
4 posted on 12/01/2003 12:58:53 PM PST by Billthedrill
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To: newgeezer
If I was a veg I would not want my body kept alive just because the mad scientists knew how to do it. Why keep me from going where I want to go.
5 posted on 12/01/2003 1:05:07 PM PST by biblewonk (I must answer all bible questions.)
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To: biblewonk
Then make sure you fill out a living will.

There are people, however, that do want to be kept alive and their rights need to be protected.
6 posted on 12/01/2003 1:07:39 PM PST by Bikers4Bush
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To: wisconsinconservative
Considering the cost of a hospital visit, I've left word that if I'm ever in a vegetative state, don't hook me up to machines. Let me leave this world as quickly as possible.
7 posted on 12/01/2003 1:09:32 PM PST by lilylangtree
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To: biblewonk
Who has the final say in whether you, a married adult, are a "veg"? Your spouse? Your parents? A judge? The Governor? What if you have no "living will," but your spouse says you told her that was your wish? (Hello, Terri Schiavo.)
8 posted on 12/01/2003 1:21:08 PM PST by newgeezer (fundamentalist, regarding the Constitution AND the Holy Bible, i.e. words mean things!)
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To: biblewonk
Would you want some other person to decide that your life "was not worth living" and kill you -- so you could get to where you were going?
9 posted on 12/01/2003 1:21:08 PM PST by been_lurking
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To: biblewonk
I resent the verdict being put into the hadns of someone else, who may or may NOT have my best interests at heart. NEVER leave ethics open to the interpretation of liberals. Liberals are socialists, and socialists gave us Hitler's final solution. I see nothing but the same, slippery slope here.
10 posted on 12/01/2003 1:28:06 PM PST by cake_crumb (UN Resolutions = Very Expensive, Very SCRATCHY Toilet Paper)
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To: wisconsinconservative
Disestablish the AMA!

No 'Doctors of Death', please!
11 posted on 12/01/2003 1:43:36 PM PST by headsonpikes (Spirit of '76 bttt!)
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To: newgeezer
and what I wonder if you are severely brain-damaged, and function at the level of a four year old or a one year old? And the impaired you is fortunate enough to be well-cared for and happy? Does the living will of the old you outrank the new you who actually experiences the damaged state?

Mrs VS
12 posted on 12/01/2003 2:13:37 PM PST by VeritatisSplendor
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To: wisconsinconservative
I think I should be in charge of when everyone dies...that would be fair.



13 posted on 12/01/2003 2:17:36 PM PST by Gringo1 (Learn to speak Spanish or you cannot order a happy meal.)
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To: biblewonk
In Terri Schiavo's situation, however, the murder-of-choice is by withholding food and water. Are you saying you would want to be starved to death?
14 posted on 12/01/2003 3:04:24 PM PST by Saundra Duffy (For victory & freedom!!!)
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To: newgeezer
Hello, Terri Schiavo

Indeed.

15 posted on 12/01/2003 3:05:18 PM PST by Saundra Duffy (For victory & freedom!!!)
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To: biblewonk
Nice tagline..... (I must answer all bible questions.)

I'm so glad to meet someone that can answer all of the questions I have on what the Bible says. I've read where we have free will but I understand that to mean that we choose to accept or deny Christ. If you choose to deny Him, you choose sin and death.If you choose to follow Him, you choose to submit to His authority and life eternal. Do you believe this?

Where in the Bible does it say that we can place our will above His? Where does it say we can choose our beginning or our end?

Why keep me from going where I want to go

Why don't you seek God's will for your life instead of telling Him what your will is?

16 posted on 12/01/2003 6:19:05 PM PST by Krodg
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To: Krodg; biblewonk
Why don't you seek God's will for your life instead of telling Him what your will is?

Good point! I know that whenever I tell God about my plans for my life, He's usually quite humored at my stupidity! And then He reminds me who's the boss! After I learn to laugh at myself, then I usually acquiesce to His decisions. And if I'm too stubborn, He throws me off my high horse!

17 posted on 12/01/2003 11:00:50 PM PST by Ohioan from Florida
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To: wisconsinconservative
Thanks for the ping!
18 posted on 12/01/2003 11:01:28 PM PST by Ohioan from Florida
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To: newgeezer
Who Will Decide When You Should Die?

God ?

19 posted on 12/01/2003 11:01:43 PM PST by clamper1797 (Conservative by nature ... Republican in Spirit ... Patriot by Heart ... and Anti Liberal BY GOD)
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To: Gringo1
I think I should be in charge of when everyone dies...that would be fair.

I think you may find it a rather time consuming occupation

20 posted on 12/01/2003 11:03:44 PM PST by clamper1797 (Conservative by nature ... Republican in Spirit ... Patriot by Heart ... and Anti Liberal BY GOD)
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