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Texas Catholic Bishops Endorse Utilitarian Futile Care Theory
LifeSiteNews ^ | 5/3/07 | Hilary White

Posted on 05/03/2007 3:58:20 PM PDT by wagglebee

AUSTIN, May 3, 2007 (LifeSiteNews.com) – The Catholic Bishops of Texas have endorsed a utilitarian theory that allows doctors and hospital bioethics committees to refuse life-saving treatments to patients who need and request them.

Renowned lawyer and bioethics critic Wesley J. Smith has slammed the Texas Catholic Conference for opposing a bill that would allow patients an extra ten days to find alternate care facilities for patients who have been refused care on utilitarian grounds.

A 1999 Texas law allows doctors and hospital ethics committees to refuse life-saving treatment even if a patient or family specifically requests it. Under the law, Patients’ families who have received notice that life-saving treatment will not be offered have ten days to find alternate care facilities.

Texas Catholic Conference spokesman, Bishop Gregory Aymond of the Diocese of Austin, said to the House Committee on Public Health, “the tradition of our Church has always taught, that a person should be allowed to die with dignity and have a peaceful death.”

Smith writes that the bishops have missed the point and are endorsing a utilitarian principle that has endangered the lives of patients.

Bill HB 1094 would change the 10-day window to 21 days. It would, however, allow hospitals to refuse new forms of treatment that might be needed during the waiting period. The statute would remain in place that says, “The physician and health care facility are not obligated to provide life-sustaining treatment.”

Bishop Aymond testified, “We believe that that is in conformity to God's will and that God is the one who chooses life and death. It is the teaching of the Church that we should not interfere with that. We also realize that sometimes families, through no fault of their own, are really not able to make those decisions because of their involvement, because of the emotions.”

Smith responded to Bishop Aymond, saying, “This is little different than utilitarian bioethicists claiming that families shouldn't be able to make such decisions because of the guilt they feel or misplaced religious belief.”

The bishops, says Smith, have confused the legitimate option for a patient to refuse unnecessary treatment, with an existing law that allows hospitals to threaten the well-being of patients and impose the subjective opinion that a patient is not worth saving. 
 
According to futile care theory the decision whether to treat is left to the doctor or bioethics committee who decide if a given treatment is worth the effort, based on the patient’s likelihood of recovery or “quality of life” issues. Elderly or brain damaged patients, Smith writes, are increasingly being refused ordinary care, such as antibiotics for infections, based on determinations of “medical futility.”

Read Bishop Aymond’s statement:
http://www.txcatholic.org/testimony-on-hb-3474.html

To respectfully express concerns to the Texas Catholic Conference:
1625 Rutherford Lane, Building D 
Austin, Texas, USA 
78754 

Phone: 512-339-9882 
Fax: 512-339-8670

Read related LifeSiteNews.com coverage:
Alert Woman Threatened With Death After Houston Hospital Votes to Remove Life Support
http://www.lifesite.net/ldn/2006/apr/06042508.html


TOPICS: Culture/Society; Government; US: Texas
KEYWORDS: bioethics; catholic; euthanasia; moralabsolutes; prolife; utilitarianism
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To: hocndoc
>> Mrs. Vo is still receiving home dialysis. (Her daughter is a doctor, BTW.)

Are you quite sure of this? IIRC, we had a report months ago that Mrs. Vo had died. I do not have a link. The daughter's name is Loann Trinh, I believe.

61 posted on 05/15/2007 7:19:58 PM PDT by T'wit (Visitors: you come here expecting a turkey shoot, and then you find out that you are the turkey.)
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To: BykrBayb
>> I can’t remember the full of name Vo

Venlang Vo, but she was also referred to as Yolang Vo. Don't ask :-) I haven't the faintest idea why the different names. She had a husband, Mr. Tran or something close to that. We did not hear much about him except that he was devoted to her and took care of her with infinite love and patience.

Andrea Clarke's sister visited the Vo family and wrote about it. I think it was posted on the Terri Schiavo site. That's as far as my memory stretches. Hope it gives you some leads.

62 posted on 05/15/2007 7:25:58 PM PDT by T'wit (Visitors: you come here expecting a turkey shoot, and then you find out that you are the turkey.)
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To: hocndoc; BykrBayb
By an astonishing piece of luck, I found this post referring to Mrs. Vo's death, apparently in October, 2006. It even has photos.

Death of Mrs. Vo

63 posted on 05/15/2007 8:08:26 PM PDT by T'wit (Visitors: you come here expecting a turkey shoot, and then you find out that you are the turkey.)
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To: T'wit; hocndoc

Thank you T’wit. One of my favorite things about Free Republic is the vast knowledge and expertise of some of the members here, like you.

Hocndoc, you’re right that neither of these women were denied dialysis. Nobody claimed they were. The fact is, they were both threatened with denial of dialysis, and their families had to hire a lawyer (Jerri Lynn Ward) to fight for their right to continue receiving dialysis, in accordance with the stated wishes of both women.

Andrea Clarke’s family did not allow her ventilator to be turned off. Yet you claim to have knowledge that they did. Where are you getting that information? You speak with the authority of one who has inside information, but you’re giving out false information.

I’d like to know where you got the idea that kidney failure is relatively painless. Would you really subject your patients to that? You can’t be serious.


64 posted on 05/15/2007 10:05:39 PM PDT by BykrBayb ("We will not be silent. We are your bad conscience. The White Rose will give you no rest." Þ)
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To: BykrBayb
>> One of my favorite things about Free Republic is the vast knowledge and expertise of some of the members here

I am continuously amazed at the depth of expertise thousands of Freepers, pulling together, can offer. I don't believe I've ever seen a subject that Freepers can't address with specialized, Ph.D.-level knowledge. The Terri Schiavo case involves a lot of medicine, so it is specially satisfying and useful that we have doctors aboard. Polybius (a radiologist) blew a fatal hole in one of the mainstays of "right to die" propaganda, namely, that CT scan of Terri's brain vs. that of a healthy young woman. The propagandists used non-comparable slices to make Terri's look bad. As you and I have seen, every little armchair radiologist, with no medical training whatever, was able to read those brain scans and tell us how hopeless Terri was. (Wikipedia still shows the scans, or did the last time I looked.) Not one picked up that they were being conned.

65 posted on 05/16/2007 6:03:52 AM PDT by T'wit (Visitors: you come here expecting a turkey shoot, and then you find out that you are the turkey.)
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To: BykrBayb

Tagline practice :-)


66 posted on 05/16/2007 6:11:18 AM PDT by T'wit (Nicolas Sarkozy: my Democrat candidate for US president. He's more patriotic than any of them.)
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To: T'wit

Thanks T’wit. I missed that news. I pray for peace for her family.


67 posted on 05/16/2007 8:54:51 AM PDT by hocndoc (http://www.lifeethics.org/www.lifeethics.org/index.html)
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To: hocndoc

You’re most welcome. I’ve added my prayer for the family.


68 posted on 05/16/2007 8:59:46 AM PDT by T'wit (Confidence in science rests on belief in God's order and will not long survive loss of belief.)
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To: BykrBayb

BykrBayb,

Your comment # 27 implied that patients had been denied dialysis, and I asked about it. That’s the problem with these long conversations, over time: it’s easy to forget what we were talking about.

It’s obvious that Andrea Clark’s ventilator was turned off, since she was declared dead. There was no attempt to support her circulation (pacer, surgery for the heart), the ventilator and monitors were purposefully turned off.

However, since you asked: I have been in meetings with the team taking care of Mrs. Clarke at least once a month, sometimes more often, as we worked on the language for the amendments to improve the Texas Advance Directive Act.

The family let Mrs. Clarke die when she had a heart attack a few days after the gall bladder aspiration proved to be futile, after her blood pressure failed and she appeared to be septic - or to have an overwhelming infection. They decided to allow her heart to stop.

A trial of dialysis, ventilators, pacers, blood pressure support, and feeding is the right thing to do in most of the cases we’ve heard so much about. They are also guaranteeing that the patient’s last days will be spent in the hospital ICU where they are separated from their families and familiar surroundings, where visitors are restricted in number and times of visits. They will be surrounded and invaded with monitors, subjected to labs, suctioning, IV replacements, and the complete loss of any hope of modesty.

The problem with Mrs. Vo and with Emilio Gonzales is that no one can order a surgeon to sign on to a case and perform as directed. Mrs. Vo needed a shunt placement for dialysis and Emilio’s lawyers are demanding a tracheostomy and feeding tube placement. None of their doctors perform these procedures. Who are you going to impress into service?

I’m a family doc. I’ve sat with patients and families, I’ve been called to the ER and the nursing home for patients who present in acute renal failure and taken care of a couple of patients who died after they refused dialysis. (One poor woman’s bones had become so brittle from bedrest and years of dialysis that her legs broke when we transferred her to the gurney to go to dialysis.)

The most striking symptom in elderly or debilitated patients is the effect of renal failure on the brain. They get sleepy and their mental status goes down fast. They look like they’ve had a stroke. It’s much better than a heart attack or an actual stroke, because the patient is in no pain, usually unaware, and they stop being hungry or thirsty. Sometimes there’s fluid backup or respiratory problems, but not usually, since the symptoms progress so fast.

On the other hand, adjusting IV and tube feedings, restricting fluids, dealing with the anemia, itching and blood pressure ups and downs - usually it bottoms out - that accompany dialysis in patients with heart or vascular disease, are a continual manipulation of the patient as well as meds and labs. I hate writing fluid restrictions for anyone — much less in dying patients.


69 posted on 05/16/2007 10:36:35 AM PDT by hocndoc (http://www.lifeethics.org/www.lifeethics.org/index.html)
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