Posted on 07/11/2009 8:24:57 AM PDT by wagglebee
Futile Care Theory is bearing down on us now like a…well you pick the cliche`. But it isn’t a joke. If you want treatment, and the bioethics committee of a hospital thinks it is “non beneficial,” your stated desires mean very little.
Now the San Diego Medical Association has adopted a futile care policy. According to the SDMA, patients “always have the right to refuse treatment.” But it’s a one-way street–and your advance directive can be overruled. From the new “Model Hospital Policy on Non-Beneficial Treatment and Conflict Resolution”:
A healthcare provider or institution is not obligated to comply with healthcare instruction(s) or decision(s) that requires non-beneficial treatment or treatment contrary to generally accepted healthcare standards.
This agenda has been on the drawing board for a long time. Indeed, in an infamous 1970 editorial in the California Medicine (California Medical Association), an anonymous editorialist promoted “death control,” which, in a sense, is what we are now facing:
The traditional Western ethic has always placed great emphasis on the intrinsic worth and equal value of every human life regardless of its stage or condition . … This traditional ethic is . . . being eroded at its core and may eventually be abandoned . . . [Hlard choices will have to be made . . . that will of necessity violate and ultimately destroy the traditional Western ethic with all that portends. It will become necessary and acceptable to place relative rather than absolute values on such things as human lives. . . . One may anticipate . . . death selection and death control whether by the individual or by society.
Well now it’s here, and “the bioethicists” and the medical intelligentsia are literally redefining the purposes of medicine. As that old California Medicine editorial predicted, life is ceasing to be an absolute value–even if you want to live–when the doctors and bioethicists think it isn’t “beneficial.” In such cases, what you think, or your family thinks, is irrelevant.
This is a duty to die, and once they force Futile Care Theory into ordinary medical practice, believe me, it won’t stop there.
We are already on the "slippery slope" and we are nearing the abyss.
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Those of us on the Terri threads knew this was coming. All those people with directives think they’re safe.
And the reality is that we aren’t safe.
Used to be, if you didn’t have the money for high level professional medical care you didn’t get it and you and your family knew you weren’t going to get it. Now days everybody expects it.
Used to be, in your last days your family would take care of you if possible. That seems less and less possible today.
How are decisions to be made and by whom?
How are limited resources to be allocated?
Despite what you are told by the left, the overwhelming majority of Americans have medical insurance to pay for this. This is about doctors DECIDING that certain treatment is futile, regardless of cost.
How are limited resources to be allocated?
Another leftist MYTH, it simply has no basis in fact.
Under Obamacare this will be common place except that government bureaucrats will determine who is worthy of getting treated and who dies.
Used to be, the weakest in the clan were left to the wolves. What’s your point?
“Used to be, in your last days your family would take care of you if possible. That seems less and less possible today.”
I assume people just fork over some money for an agency to send someone to help, let the parents’ debts pile up, or let medicare pay for whatever it pays for. Getting very closely personally involved on a daily basis? The only people I know who do that are a few stay-at-home moms, or immigrants from foreign countries where having an elderly parent living with you is normal.
I think we are getting very far away from the notion that there is work in this world which doesn’t come with a paycheck, but is incredibly valuable, nonetheless. When my mother was dying, my sister-in-law came to stay with her for several weeks. She could do that because she was an empty-nester who wasn’t working. It really hit me how few people are left in the world who have the flexibility to do that, because they put a priority on caring for loved ones, and they had one steady income, with her getting a job occasionally, when the family didn’t need her more at home.
Inspired by my sister-inlaw, I’m doing a temporary stint at my father-in-law’s house, although he is not dying. He is just semi-incontinent and mid-stage Alzheimers. I’m babysitting him for several weeks while my mother-in-law recovers from surgery. He has a pleasant personality, but I can tell you even this has its unpleasant and odiferous moments, and it is nothing compared to somebody who needs pain management, help moving, etc. I don’t know if people in the past did home care for the dying because they were more generous people, or simply that there was no choice, because there is plenty of room for developing resentment and callousness, etc., when caring for someone, unless you are bound and determined to do it with love every day, all the time.
It’s a high calling to holiness to take care of people who have unpleasant health problems, and since everybody has a problem like that at some point in their life, there is no lack of opportunity to accept the calling. But I’m not expecting the public to hear it, especially not those who can better maintain their comfortable lifestyle by distancing themselves from it. The only reason I’m not working at a nice office where everybody smells good is because my husband agrees with me about putting care-giving first, and is willing to pull down the money. And the only reason I’m concerned with it at all, because I’m by nature intellectual, squeamish and spoiled, is because of my sister-in-law, La Leche League, and ultimately my faith.
So, ultimately, lack of money could bring more family care, but it won’t come voluntarily for most people, and may or may not result in kind and loving care, depending on whether the building blocks are in place, in terms of budget and commitment to the calling.
That’s the same as not having any choice at all. In other words, mandated euthanasia. The same thing with a different name.
Despite what you are told by the left, the overwhelming majority of Americans have medical insurance to pay for this.
That may be true if you include Medicare and Medicaid and it may not be true if you don’t. In any case, insurance rates factor in costs and spread the risk and the cost over a group. Previously I wrote:
Used to be, if you didn’t have the money for high level professional medical care you didn’t get it and you and your family knew you weren’t going to get it. Now days everybody expects it.
They expect it because they, in your words, have medical insurance to pay for this, If insurance allows them to get a high level professional medical care which they could not otherwise afford, then it is because the rest of the insured are helping them to afford it, the rest of the insured are paying for it too. Now that’s not all bad and I can live with it. You might not like it after you think about it because it smacks of a Leftist transfer of wealth, a “Socialism as part of a business model” kind of thing. Not to mention the fact that ill advised procedures may drive up your personnel insurance costs. But the point is that it is not sufficient to say “the overwhelming majority of Americans have medical insurance to pay for this”.
This is about doctors DECIDING that certain treatment is futile, regardless of cost.
Should they have no decision? Should they be forced to accomplish procedures against their will? If the procedures do not turn out to meet the expectations of the patient and family, should they be sued/punished for accomplishing procedures they didn’t want to accomplish in the first place? Should everybody who helps pay for the procedure get a say?
Another leftist MYTH, it simply has no basis in fact. (In response to: “How are limited resources to be allocated?”)
One available heart for a transplant, two people need it. The resource is limited.
One specialist for a ten hour operation which two people need that day. The resource is limited.
Closing Comment: None of this is simple.
“What’s your point?”
Change happens.
I think the oldies used to live with the extended family because health didn’t deteriorate very much before someone died. Now, lives are extended but folks are more debilitated; this makes them more difficult to take care of at home.
I have watched my mom and a friend’s mom both deteriorate over time; there was a point for each where help was needed way beyond what we were able to provide. The other thing they got, with the move to a good facility, was lots of people around. Patient would be very isolated in a single family home with everyone off to work, etc.
We do not have extended families living together the way families did 100 years ago.
The bulwark against this will continue to be the Catholic Church, which has been dogmatically consistent in these matters.
Sadly, that bulwark may not be as effective as desired.
Happily, many will come into the Church because they will come to recognize it is the custodian of the entire deposit of faith.
In Ireland, it used to be pretty futile for the IRA to even try to fight the British army head to head, following rules warfare that limited the struggle to massed forces alone. The IRA represented the great number of citizens being oppressed by the bureaucratic forces of government, much as the patients being effectively euthanized by these faceless, nameless bureaucrats.
Then along came Michael Collins who set out to make it all personal. Names, faces, addresses of the anonymous bureaucratic officials making the decisions sentencing the Irish to death by army. The entire nature of the struggle changed, and the British were made to feel acutely the consequences of their bureaucratic, impersonal, made-from-a-safe-distance decisions.
Can you see where this is going?
You say that like it’s a bad thing. Our ability to take better care of people is a good thing. There is no need to revert to prehistoric methods.
My father died last March at the age of 96. He had a rather minor stroke, but unfortunately aspirated saliva and developed a very serious pneumonia.
My brothers and I struggled with decisions that involved “futile care”.
Thankfully, my brothers and I were all in agreement on these matters. If there had been any reasonable hope for overcoming the pneumonia we would have been very aggressive in treatment. In the end we decided against intubation, respirators, ICU care, and surgery. It seemed “futile” to us to subject my father to treatment that would have been torture for him when there was almost no hope for recovery.
“You say that like it’s a bad thing.”
I didn’t mean it that way.
I meant that, in the case at hand, the health care situation and society have changed so that there are more and sometimes different options. Decisions have to be made about which option to take. That begs the questions (reference my post 6):
How are decisions to be made and by whom?
How are limited resources to be allocated?
“Our ability to take better care of people is a good thing. There is no need to revert to prehistoric methods.”
Agreed.
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