Thread by NYer.
"Praise God! After months of tireless effort from American Life League and pro-life heroes in Boston and around the country to expose a potential scandal only days away from becoming a tragic betrayal of Catholicism's unwavering commitment to the dignity of the human person, Cardinal Sean O'Malley has heard our voices and will end the joint venture with abortion-providing Centene Corp!
We profoundly thank Cardinal O'Malley for his courage, leadership and pastoral concern for the health and well-being of those youngest members of his archdiocese. He has set a beautiful example of dedication and charity for those poorest of the poor - the preborn.
Cardinal O'Malley has answered our call and beat the clock as the minutes ticked away until the July 1 launch of the new CeltiCare Health Plan and the Catholic Church's participation in the intrinsic evil of abortion.
Together with the thousands of American Life League supporters whose voices cried out in horror to the Cardinal at the thought of the Archdiocese of Boston supporting and promoting abortion, we congratulate Cardinal O'Malley on his commitment to the Faith - even during this time of severe financial crisis. . .
Threads by me.
A UK bioethicist named Daniel K. Sokol, who writes nary a word in opposition to Futile Care Theory, aka medical futility (meaning, I suspect, he is a futilitarian), has nonetheless written a valuable informative essay in the British Medical Journal (no link, 13 JUNE 2009 | Volume 338) called “The Slipperiness of Futility.” For example, he defines the different “kinds” of futility:
Although ethically aware clinicians need not be familiar with the vast literature on the concept of futility, they might wish to remember the following four points: • Futility is goal specific. • Physiological futility is when the proposed intervention cannot physiologically achieve the desired effect. It is the most objective type of futility judgment. • Quantitative futility is when the proposed intervention is highly unlikely to achieve the desired effect. • Qualitative futility is when the proposed intervention, if successful, will probably produce such a poor outcome that it is deemed best not to attempt it.
And he points out, physiological futility–which I think a physician should refuse–is the only objective “type.” Indeed, Futile Care Theory isn’t about truly futile interventions, but about withdrawing wanted treatment based on the medical team’s or bioethicists’ values:
As futility is so rhetorically powerful and semantically fuzzy, doctors may find it helpful to distinguish between physiological, quantitative, and qualitative futility. This classification reveals that a call of futility, far from being objective, can be coloured by the values of the person making the call. Like “best interests,” “futility” exudes a confident air of objectivity while concealing value judgments.
Sokol tries to erase the abandoning nature of Futile Care Theory by pulling out the old bromide:
Furthermore, “futile” suggests that nothing can be done. Recall the ancient medical wisdom: “To cure, sometimes. To relieve, often. To comfort, always.” There is always something to be done.
That’s true, as far as it goes, but when you want to live and the bioethicists/physicians don’t think the quality of life is worth the effort or the money, saying that you are still providing “care” rings pretty hollow.
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Stories like this continue to mount in the UK, and are a warning to us of the growing utilitarian, quality of life/cost-benefit bent in health care. A stroke patient, it is charged, was almost neglected to death–if not worse–at a UK hospital. From the story:
John MacGillivray, 78, from Auchterarder, was admitted to Perth Royal Infirmary having suffered a stroke on May 22. Two days later, his family were told by hospital doctors he would die within hours. His daughter Patricia MacGillivray told Sky News:…”There were several issues we already had with the level of care he had received in the short while he had been in the hospital, so we started to become suspicious. That’s when we started asking about his medication. It was then we learned that the medication we had been told he was going to receive when he was first admitted, which was specifically for stroke, had been changed to medication for treating seizures which we’d never seen him have.
The MacGillivray family instructed doctors to immediately withdraw all medication and launched a round-the-clock bedside watch.Within two days, Ms MacGillivray says her father had made such a good recovery he was being recommended for stroke rehabilitation treatment and four weeks later he was back home walking around his garden in Auchterarder. Ms MacGillivray feels if her family had not intervened in the treatment her father was receiving at Perth Royal Infirmary then her father would not be alive today. “The effect of that medication was to sedate him.”
Not to prejudge the matter, but I think that is a pretty good bet. Indeed, if my private e-mail is any judge, the disdain for the moral worth within the health care community for elderly people with serious brain injuries or illnesses is growing here too. (That being said, I believe American health care remains fundamentally moral precisely because of the people working in the trenches at hospitals and in nursing homes.)
Stories such as these are all very depressing and bring to mind the prescient warning by Dr. Leo Alexander printed in the New England Journal of Medicine in 1949 in the wake of the Nuremberg Medical Trials, for which he was chief investigator:
In an increasingly utilitarian society these patients [with chronic diseases] are being looked down upon with increasing definiteness as unwanted ballast. A certain amount of rather open contempt for the people who cannot be rehabilitated with present knowledge has developed. This is probably due to a good deal of unconscious hostility, because these people for whom there seem to be no effective remedies, have become a threat to newly acquired delusions of omnipotence… At this point, Americans should remember that the enormity of the euthanasia movement is present in their own midst.”
Question: Given the changes in ethics at the NEJM, given its editors pushing assisted suicide–even, in a bitter irony, respectfully publishing the Groningen Protocol bureucratic check list as to which babies are to be murdered by doctors based on quality of life judgments–would it even publish Alexander’s article today?