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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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The one in one hundred chance comes up one in one hundred times. Hope should not be too quickly abandoned.

Exactly!

1 posted on 05/14/2011 10:42:08 AM PDT by wagglebee
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To: cgk; Coleus; cpforlife.org; narses; Salvation; 8mmMauser
Pro-Life Ping
2 posted on 05/14/2011 10:43:15 AM 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; Sun
Ping
3 posted on 05/14/2011 10:43:47 AM 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; AKA Elena; Albion Wilde; Aleighanne; Alexander Rubin; Amos the Prophet; ...
Moral Absolutes Ping!

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

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4 posted on 05/14/2011 10:44:29 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
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 posted on 05/14/2011 10:51:51 AM PDT by Tax-chick (Obama's "Gutsy Decision": Who's gonna tell the fool that he ain't cool?)
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DONATE

6 posted on 05/14/2011 10:55:05 AM PDT by TheOldLady
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To: wagglebee

While there is life, there is hope.


7 posted on 05/14/2011 10:56:10 AM PDT by Blood of Tyrants (Islam is the religion of Satan and Mohammed was his minion.)
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To: wagglebee
Eventually this has to become an issue of who is paying for the care. If the person's personal funds are being used then there should be no interference with the families or the persons wishes. If insurance or public funds are used the cost becomes an issue and someone outside the family will decide..
8 posted on 05/14/2011 11:37:05 AM PDT by montanajoe
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To: wagglebee
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.”

This "meme" is what is used in order to essentially kill someone legally. And it's been widely accepted because it comes from the medical community. This basically confirms the discussion from yesterday's thread.

9 posted on 05/14/2011 11:38:10 AM PDT by Outlaw Woman ("...; because thou hast rejected knowledge, I will also reject thee,... "Hosea 4:6)
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To: wagglebee

What if she hadn’t recovered? I’m getting tired of the assumption that the only justification for not killing the patient is the hope that he/she will recover. What ever happened to treating people humanely even if they had a permanent disability or terminal condition?


10 posted on 05/14/2011 11:43:29 AM PDT by BykrBayb (Somewhere, my flower is there. ~ Þ)
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To: Outlaw Woman; wagglebee

I think this view of no quality of life comes from the mechanistic world view. If people are just machines made of meat, evolved accidentally without any purpose or transcendent meaning; if there is no soul which is the source of life; then the machine which isn’t functioning well might as well be scrapped. And of course used for parts.

The value of each person is not because they might become useful, or paint pictures, or do something great, or become able to care for themselves, or even get well or better. The value of each person is because each person is a soul who belongs to God.

Take this basic understanding away and humans become mere machines, and what do we do with machines that can’t be fixed? Why, what my DH does - takes them apart and uses the useful parts and the rest goes to the dump.

Take away God and the result is hell, with all the attendent atrocities, cruelty and suffering.


11 posted on 05/14/2011 11:45:18 AM 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: BykrBayb

See mu comment just above.


12 posted on 05/14/2011 11:47:07 AM 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: little jeremiah

Well said.


13 posted on 05/14/2011 11:51:22 AM PDT by BykrBayb (Somewhere, my flower is there. ~ Þ)
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To: BykrBayb
I’m getting tired of the assumption that the only justification for not killing the patient is the hope that he/she will recover. What ever happened to treating people humanely even if they had a permanent disability or terminal condition?

Excellent point!

14 posted on 05/14/2011 11:52:08 AM PDT by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: montanajoe; Dr. Brian Kopp; trisham; DJ MacWoW; little jeremiah; Coleus; narses; Lesforlife; ...
If the person's personal funds are being used then there should be no interference with the families or the persons wishes. If insurance or public funds are used the cost becomes an issue and someone outside the family will decide..

So ultimately you are fully in favor of death panels for essentially ALL Americans?

Are you aware that people actually pay for health insurance?

15 posted on 05/14/2011 11:57:15 AM PDT by wagglebee ("A political party cannot be all things to all people." -- Ronald Reagan, 3/1/75)
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To: little jeremiah

lj, you have perfectly captured the essence of a godless society in your post and it’s absolutely chilling.


16 posted on 05/14/2011 11:58:02 AM PDT by Outlaw Woman ("...; because thou hast rejected knowledge, I will also reject thee,... "Hosea 4:6)
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To: little jeremiah
Take away God and the result is hell, with all the attendent atrocities, cruelty and suffering.

Well said, LJ.

The bottom line of Communist, godless ideas is that collectivism and progressivism need MONEY. They take it from everybody and spend it on their cronies and pet programs.

They want an old, sick person to be treated exactly like an old, mechanically troubled car. Better "junk it" than "spend money" to fix it...it ain't worth the expenditure!

When it comes to one of the old Communist rules, he's treated like a brand-new Rolls Royce and no expense spared.

Communism enslaves and has no soul.

17 posted on 05/14/2011 11:58:47 AM PDT by melancholy (Papa Alinsky, Enslavement Specialist)
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To: wagglebee
I am aware that people pay for insurance and I am also aware that everyday insurance companies don't pay for what is paid for..get sick you will find that our..

But my point stands as much as I may like to provide care the ultimate driver of the decision will be the cost if either insurance or public funds are used. You may disagree with that but its a fact..

18 posted on 05/14/2011 12:05:13 PM PDT by montanajoe
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To: wagglebee

Then I guess the argument becomes that if the person can no longer pay the insurance premium how long are they obligated to cover the patient? Making coverage lifelong after a catastrophic incident would destroy the insurance industry and cause more deaths. Turning to the government compounds the problem.

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. If god wants the person to pull through they will one way or the other. If you link a man up to a machine and that machine sustains him without hope of recovery then as far as I’m concerned your denying him his final rest.

As this country gets poorer and the debt problem compounds this will start to happen with death panels or not. The best thing to do is to consult with the family (if there is any) and the caring doctors to decide whether the expense of keeping someone hooked up is justified. No sane person would want his corpse to be kept warm to kill another individual who has a chance at life. As stated if the individual can pay for his own bed through family or personal savings then there isn’t a problem.

Unless god suddenly decides to shower us with enough wealth to keep these people alive then all of us have to face the fact that entropy always wins and life comes to an end.


19 posted on 05/14/2011 12:05:39 PM PDT by utherdoul
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To: montanajoe

So if your neighbor gets tired of paying his children’s food, clothing and other expenses he should be allowed to kill them? Or does your moral code only apply to those “untermenschen” you deem to be lebensunwertes leben?


20 posted on 05/14/2011 12:06:01 PM PDT by BykrBayb (Somewhere, my flower is there. ~ Þ)
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