Futile Care Theory Strikes Again-What will the Pro Choice and Pro Life Communities Do About It?


        Futile Care Theory strikes at the very heart of  both pro choice and pro life conviction. One being that each individual should be able to choose what happens to her or his own body and that each individual, regardless of age, race, gender, ideology, disability, or even whether or not they have been born yet, has a right to life. Pro life and Pro choice people can be united in condemning the imposition of futile care theory on patients and their families.

        Yet, these impositions continue to occur with little news coverage and, sadly, little cooperation between these communities in stopping it. Not that there haven’t been cooperations. In 2007, both the Texas Right to Life Committee and the Texas ACLU fought for the right of Catarina Gonzales to decide to continue her son, Emilio’s life support until he died of natural causes.

        A few years ago, doctors in Winnipeg, Canada attempted to withdraw life support from Samuel Golubchuk. He also died while his family was fighting this imposition. Recently, Winnipeg Canada is in the news once again as it seeks to discontinue the life support of a baby against his parent’s wishes. The baby, Isaiah James, has shown signs of improvement, such as gaining weight and breathing on his own, even though doctors said that he would never do this, yet the doctors are still fighting to withdraw treatment, and his family is still fighting the doctors.

        My question is: why aren’t pro life and pro choice indivivduals working together to address and stop these travesties? In VA and TX laws also exist giving doctors the right to withdraw treatment against a patient and/or his family’s wishes. This is a threat to both the sanctity of life and the sanctity of personal choice, thus, both pro life and pro choice people have a stake in this matter. Why, outside of pro choice disability rights websites and right to life websites, has no one mentioned this case? Is it because people with the ideals that are simultaneously compromised aren’t communicating enough with one another, or that people on both sides have become apathetic?

        One thing I do know: The founders of the free societies in America and Canada did not go through everything they went through so that people’s basic right to exist could be trampled on by people who think they know who should live and who should die. As people who value life and choice, we should be united on this.

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  • crowepps

    These cases are just so tragic — the families want desperately for the hospital to try everything possible to keep their loved ones’ bodies alive in hope some miracle will occur. I think one of the reasons that people don’t make political footballs out of these cases is out of respect for how painful their squabbling over the issue would be to the family.

     

    He is such a darling little guy. What a shame that his family has to go through this. The judge’s decision to bring in an outside, expert opinion to assess his condition was very wise.

  • progo35

    Yes, it is very tragic. I am bothered by the fact that this is even up for discussion in a free nation. Clearly, it is wrong for hospitals, doctors, ethicists, or anyone else to say who has the right to treatment and who doesn’t. It should be the family’s decision (unless they’re starving him to death or denying surgery on a non terminal child because of handicap), period.
    It disgusts me that families have to go through this because they are being harassed by the hospital or their loved one’s doctors. If doctors are SO SURE that death is imminent, the doctors need to leave his family alone so that they can at least prepare to loose their child in peace.
    quot;Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • crowepps

    The baby was not breathing when born, was resuscitated and his body has been kept alive by a ventilator ever since. Without the ventilator he wouldn’t have survived a day.  There is no discernible higher brain function.

     

    Is there any point at which the family’s refusal to accept that his lack of brain function means he will never breath on his own becomes unreasonable to the point that it should be ignored?  Is the only acceptable sign of death now corruption?

    It should be the family’s decision (unless they’re starving him to death or denying surgery on a non terminal child because of handicap), period.

    It doesn’t seem to me to be possible to insist the entire decision should be the families, period, but then qualify it by saying that this only if their decision conforms with your own perspective.

     

    Putting the decision in a list of supposedly objective rules is exactly the situation that ProLife activitists are protesting against.  The way the law works, the choice is between either the family getting the entire decision no matter what they decide or the decision being lodged a set of rules like that the doctors are using when they consider whether the treatment has any hope of helping the patient recover.

     

    I can see where you could argue that your rules are preferable to the doctor’s rules but you can’t simultaneously argue ‘the parents have the right’ AND ‘the parents have to follow my rules’.

  • progo35

    "The baby was not breathing when born, was resuscitated and his body has been kept alive by a ventilator ever since. Without the ventilator he wouldn’t have survived a day. There is no discernible higher brain function."

     

    The baby HAS breathed on his own and has gained weight, Crowepps. As for "brain function" that is also disputed in terms of what that actually means. Does that mean "brain dead"? "PVS"? "Brain injured"? You’ll find that in the medical community, "the absence of higher brain function" can mean any of these things.

     

    As for starving someone to death or denying surgery on the grounds that an infant has a disability, are you really suggesting that parents who neglect their children in this manner ought to have their wishes upheld? Are you suggesting that this is the same thing as withdrawing life support from a dying child? When parents deny surgery to a child who is nondisabled, those parents are brought up on neglect charges. These aren’t my rules, but the rules of most, if not all, states in America.  Except, perhaps, when the child has a disability, like Down Syndrome, which is a discriminatory policy that exists in many, or all, states. This is wrong. Why should it be any different if the child just happens to have down syndrome but will respond the same way to the said operation? Ie, why is the parent’s decision to withhold surgery in this case sacrosant but in the case of a nondisabled child, it is not? 

     

    Allowing a parent’s decision to withold simple surgery from an otherwise healthy disabled child is no where near the same thing as respecting a family’s decision to withdraw a ventilator from a child who is dying. If Isaiah’s parents decide to pull his ventilator, that’s their decision, but if they want to continue it, that’s also their decision. It would not, in my opinion, be appropriate to give parents the right to order a hospital team not to feed a disabled or sick child.

     

    A child who is dying whose family decides to withdraw life support is not the same as a child who is disabled and needs a simple surgery to correct her esophogus. So, the two things just aren’t the same.
    As for "recovering," this goes to what Cat and I are saying. Some people are going to be disabled their whole life, and that is okay in the sense that they have the same right to live as you and I do-they don’t have to be fixed to have a life worth living. Doctors cannot simply allocate resources based upon who will "recover," for this results in discrimination against the handicapped.

     

    Getting back to my first point: this is something that pro life and pro choice people ought to be able to work together on. Futile care laws violate life and choice.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • ahunt

    I dunno crowepps…doctors have been wrong before, and they have sold this little guy short. Can we not consider the gift of time?

  • crowepps

    They have delayed any future decisions until he can be evaluated by an independent specialist, which I think is a really good idea.  I’m not sure where you get the idea that they have sold him short.  From what I’ve seen it looked like they made absolutely heroic efforts to save him over a far longer period than most hospitals would have considered, and they were absolutely right to do so.

  • progo35

    But the point is that it shouldn’t be “the specialist”‘s decision. It should be up to his parents, and nobody else. It isn’t particularly “heroic” for those doctors to watch around bragging about what great people they are for trying to save him and then saying that they, in their supposedly infinite wisdom, should make his medical decisions. Ahunt is right-time is a gift and the doctors have sold him short.
    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35

    But the point is that it shouldn’t be "the specialist"’s decision. It should be up to his parents, and nobody else. It isn’t particularly "heroic" for those doctors to walk around bragging about what great people they are for trying to save him and then saying that they, in their supposedly infinite wisdom, should make his private medical decisions. Ahunt is right-time is a gift and the doctors have sold him short.
    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • crowepps

    The baby HAS breathed on his own and has gained weight, Crowepps.

    I saw a statement several places that he has gained weight but I haven’t seen any source for your claim that he has breathed on his own.  Again, if he can breathe on his own, why does he need a ventilator?

  • crowepps

    I haven’t seen anything anywhere that says the doctors are ‘bragging’.  The fact that the child was resuscitated and has survived this long is pretty good indicator all by itself that they’ve done a great job, don’t you think?  Or does the fact that they’re now ready to give up mean that none of that counts anymore?  ‘What have you done for me lately?’

     

    You do understand that Canada is a single-payer country and all of the care has been provided to him for free?   And the doctors have other children being born for whom that ventilator and that hospital bed could be used but for whom it isn’t available?

  • progo35

    If you are on Facebook, go look on "Prayers for Baby Isaiah.

    Also, here is a colum written by a doctor about Isaiah’s situation:

    http://www.winnipegfreepress.com/opinion/westview/babys-status-as-human-is-on-trial-84764422.html

     

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35

    Yes, Crowepps, if you read the diary, I clearly said that it was in Winnipeg, Canada. “Bragging” is part and parcel of what the doctors are doing. They are basically saying, “look at us, aren’t we smart and nice, we actually tried to save him (for free)”! “Now that we’ve decided that his life just isn’t worth it, we’re pulling the plug, because we know more than you, Isaiah’s parents!” Moreover, it disturbs me that you cite the country’s single payer plan as a reason to justify what the doctors say. Doesn’t RH support a single payer plan here? Is discrimination against the severely handicapped what RH and it’s readers like to see happen in order to make “free” healthcare a reality? I support health care reform, but comments like yours are why many are extremely wary of it. Moreover, you are talking about a hypothetical child who might need the ventilator as opposed to the actual child using it. Furthermore, if being on a ventilator disqualifies one from his or her right to use it, why have them at all?? Your argument is illogical.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • crowepps

    But this guy isn’t one of Isiah’s doctors, is he?  He doesn’t even practice in the same city.  And he’s not a neonatologist but instead an anesthetist.  What makes him an expert?  His statement makes no sense to me.

    Brain death is complete and irreversible cessation of all brain function from the cortex to the brainstem. In some circumstances, the heart may still beat, the blood circulates and many organ systems can still operate. Patients who are brain dead are quite unstable even with the functions listed above working. Most patients with cessation of brain function experience rapid multiple organ system failure unless doctors intervene.

    Unstable and prone to rapid multiple organ system failures unless doctors intervene.  And so, even though it will make absolutely no difference to the prognosis of the patient in the long run, doctors are obligated to intervene?  How many times?  To what purpose?  This seems to me to reduce respect for ‘life’ to nothing more than the basest level - artificially sustaining the warmth in flesh irrespective of whether consciousness ever has, is or ever will be possible.

    My moral obligation as a physician demands that I not participate in the debate except to say that I treat all human beings the same.

    And that will be a pretty easy moral stance for him to maintain, since as an anesthesiologist, there won’t be any occasion in which he’s ever going to be involved in similar decisions.

  • crowepps

    "Bragging" is part and parcel of what the doctors are doing. They are basically saying

    Do you have some information I haven’t been able to locate about what the doctors are saying?  I certainly haven’t seen any quotes from them.

    Doesn’t RH support a single payer plan here? Is discrimination against the severely handicapped what RH and it’s readers like to see happen in order to make "free" healthcare a reality? I support health care reform, but comments like yours are why many are extremely wary of it.

    Oh, right, because it’s much better to have insurance companies rationing care on the basis that the patient coverage has reached their lifetime limit.  That isn’t ‘discrimination’, because it’s based entirely on the profit margin of the company.

    Moreover, you are talking about a hypothetical child who might need the ventilator as opposed to the actual child using it. Furthermore, if being on a ventilator disqualifies one from his or her right to use it, why have them at all??

    The theory behind the ventilator is, except in extraordinary cases, that the person using it will recover and no longer need it.  If recovery is impossible because there is no brain activity then it is indeed ‘futile’ – it serves no useful purpose.

     

  • ahunt

    I swiftly googled…read the first blurb that popped up. I did not even stop to check whether the site was agenda oriented, and possibly putting out bad info.

     

    This is a difficult question for me.  When my Mom issued her DNR directive, the family initially kept it from me, knowing that I would object. (Me and Mom are still tight, in my heart.)

     

    And yet it was me who was given the call, the baby of the family…without pressure or rancor…when the time came. And I obeyed my Mother. She died on her own terms, at 80, lucid and in command to the near end.

     

    We went through two consecutive stillbirths. It is old pain, but it lays like the bruise that cannot truly heal at the back of the mind.

     

    Absent higher brain function?  T’was my mother’s greatest fear, and I respect that will.  And yet with one of my own, I would just need to be sure, absolutely sure…

     

     

     

  • crowepps

    I was lucky enough to have one of my sister’s with me when we had to honor Mom’s DNR.  It is a hard thing to cope with, but knowing that they made the decision themselves does help.

    Absent higher brain function?  …  And yet with one of my own, I would just need to be sure, absolutely sure…

    I too would want to be sure, but what information source do you think you would find dependable?  Progo rejects any input from the doctors, but that would be the place I personally would turn to for information so that I could feel sure.  My assumption would be that if they had tried hard and done a good job up until then, that their collaborative decision that it was futile could be presumed to be unbiased.

  • ahunt

    My assumption would be less rational…until the fourth or fifth assessment. But you already know my emotions can get the better of me.

  • crowepps

    I think in a similar situation I would be just as emotional.  It would be interesting to know just exactly how many assessments have been done, how many doctors concur, etc., but one thing I can tell you for sure, in that situation I would be really distressed by having the whole situation used as some sort of gotcha moment to be chewed over by the blogosphere.  To me, that kind of situation just seems intensely private.

     

    It’s really hard to discuss this honestly while worrying that one of your comments might potentially be repeated to and hurtful to the parents, so even though this is really an important ethical question our society needs to come to some agreement on, I think it’s better to discuss it in the abstract, and I’m going to drop out of the discussion centered around this particular case with last wishes for his parents of acceptance and peace.

  • ahunt

    Class Act. Profoundly appreciate this, crowepps.

     

    Because, in the shoes of these parents, I would grasp at any straw. You choose not to make the personal…abstract.

     

    Thanks again.

     

    Anni 

  • progo35

    It’s fine for doctors to have input, after all they are the doctors, and they are supposed to give their medical opinion. But providing an opinion based on expertise does not entitle them to make decisions about what happens in terms of continuing this child’s care. It’s the parents decision, period. As a pro choice individual, croweepps, you should respect that. Moreover, decisions are supposed to be a combination of fact and emotion, so I think ahunt is right to say that she would make a deision based at least partially on what she feels. IF all we did was make decision based on “the facts” and didn’t have emotions, we would be robots. And, as she said, SHE made the decision regarding her mother’s DNR, not some self-aggrandizing doctor with a God complex. If one of my family members is ever ill, I expect OUR FAMILY to be able to make the decision about whether to continue treatment, not the doctors who are trying to save their single payer heath system a buck.

    Getting back to my point: this violates both pro choice and pro life principles. We may not agree on what decisions we would make when confronted with various situations or whether Isaiah’s doctors or his parents are right, but we can agree that it should be his parents’ decision, and not his doctors, when it comes to when to shut off his ventilator.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35

    Be advised that Isaiah’s parents WANT support. I’m sure that they didn’t want their situation being discussed in the blogosphere, but the futile care imposition made their private tragedy into a public matter by trying to enforce the doctors’ perspectives, legally. Now that this has happened, I think, based on reading their facebook page, that they want people to be concerned and respond to this situation by agreeing that they, not the hospital or society, should make this decision.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • progo35

    Let’s say you had a loved one who was dying of cancer who did not want to be resusitated, yet every time he or she flatlined, the doctors rushed in rescitated him or her repeatedly, and told you that it was their right to make that decision, not you, because, after all, they are the medical experts and have a deeper understanding of your loved one’s condition than you or even your loved one. Would you want to be told that that choice wasn’t up to you, but up to the doctor? What if you had to go to court to stop them from doing this because there was a law allowing them to do this to patients and families? Would you be so contemplative and on the fence about this then? I doubt it. The same logic should hold true in the case of someone or someone’s family who wants medial treatment or rescusitation. It needs to be the family’s decision.
    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • crowepps

    If one of my family members is ever ill, I expect OUR FAMILY to be able to make the decision

    Better not let them be admitted to a Catholic hospital then:

    The US Conference of Catholic Bishops released an “Ethical and Religious Directive” this month that would ban any Catholic hospital, nursing home or hospice program from removing feeding tubes or ending palliative procedures of any kind, even when the individual has an advance directive to guide their end-of-life care. The Bishops’ directive even notes that patient suffering is redemptive and brings the individual closer to Christ.

    http://news.firedoglake.com/2009/11/24/catholic-bishops-enact-plan-for-300000-terri-schiavos/

  • progo35

    What the Catholic Church does is really a moot point. I, frankly, don’t care what the church thinks or does in this particular matter, and you shouldn’t, either. The point is that the patient or patient’s family requested that the care continue and certain hospitals are attempting to withdraw care against those wishes. Regardless of one’s particular position on feeding tubes, etc, the point is that futile care laws are unconstitutional and violate fundamental principles of pro choice and pro life beliefs, yet politicians and people on both sides of that divide continue to support or ignore them. People against futile care laws are not going to agree on everything, but there is enough in common between the two belief systems to make opposition to futile care laws a pro life and pro choice issue.  

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • crowepps

    I, frankly, don’t care what the church thinks or does in this particular matter, and you shouldn’t, either.

    I’ll continue to decide what I care about myself, particularly since one of the hospitals to which patients here are Medevaced is a Catholic one.  I have instructed my daughter to refuse that choice for me if it’s ever suggested because there is also the option of a secular hospital where my care wouldn’t have to conform to someone else’s religion.

     

    Both issues hinge on the same question – who decides.  You don’t want the government deciding that they’re not willing to devote any more scare resources to hopeless cases if the family still wants an effort and I don’t want the hospital administration deciding that once they have the patient in their clutches they can ignore the patient and his/her family’s wishes and impose unwanted care.

     

    Solutions?  I’m not sure there are solutions.  Any time ‘society’ pays for the care rather the individual, it isn’t totally unreasonable for ‘society’ to want to disconnect the patient and use the machines for someone with a chance of recovery.  Certainly Terry Schiavo’s case hinged on her own wishes but the $80,000 a year her care cost and the proportion of that cost paid by Medicare was also an issue.  On the other hand, it seems heartless for financial triage to put grieving parents in a position where they are forced to accept reality before they can cope with it.

     

    One thing I do know, though, is that "hard cases make bad law".

  • progo35

    “Both issues hinge on the same question – who decides. You don’t want the government deciding that they’re not willing to devote any more scare resources to hopeless cases if the family still wants an effort and I don’t want the hospital administration deciding that once they have the patient in their clutches they can ignore the patient and his/her family’s wishes and impose unwanted care.”

    The solution is to strike futile care laws and ensure that people’s living directives are honored.

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • crowepps

    Instead of having the ‘futile care law’ end the treatment, have it instead end the funding.  If the family came up with the money out of their own pocket, then the government and taxpayers wouldn’t have any room to complain.

  • progo35

    “Solutions?  I’m not sure there are solutions.  Any time ‘society’ pays for the care rather the individual, it isn’t totally unreasonable for ‘society’ to want to disconnect the patient and use the machines for someone with a chance of recovery.”

     

    Okay, than I guess society has a say in how many kids a woman has while she’s on wellfare. (As I say this, keep in mind that I recieve disability benefits and do not concur with this argument). After all, the taxpayers are paying for the kids, so why shouldn’t we have some say in how many kids the woman has? Or, let’s say society decides to fund abortion. Then I guess we can say when a woman may have one.

     


    Instead of having the ‘futile care law’ end the treatment, have it instead end the funding.  If the family came up with the money out of their own pocket, then the government and taxpayers wouldn’t have any room to complain.”

     

    That’s no compromise, Crowepps. That’s discrimination against the poor.

     

    The only way to solve the problem is to strike down futile care laws. Period. If you want others to respect a woman’s choice to terminate, than people who are pro choice should be screaming about the impact of these laws on personal choice. Otherwise, such people are buying into huge hypocrisy. As so are pro life people who ignore or support these laws because “we could spend the money somewhere else” or “so and so is never getting better…”This is something that I believe pro choice and pro life people can work together on.

  • crowepps

    “Okay, than I guess society has a say in how many kids a woman has while she’s on wellfare.”

     

    Conservatives both promote and support providing only a certain amount of money per familiy and not providing support for additional children:

     

    “In 1992, black Democratic Assemblyman Wayne Bryant won passage in the New Jersey legislature of an innovative welfare reform known as the “family cap.” Under the family cap, mothers already enrolled in AFDC no longer receive an automatic increase in AFDC benefits after giving birth to additional children.

     

    http://www.heritage.org/research/welfare/fyi50.cfm

     

    ********

     

    “Or, let’s say society decides to fund abortion. Then I guess we can say when a woman may have one.”

     

    Yes, that’s exactly what the law is:

     

    “HR 3962… prohibits funds… from being used to pay for abortions … unless the woman would be placed in danger of death without the performance of an abortion or the pregnancy is the result of rape or incest.

     

    *****

     

    “Instead of having the ‘futile care law’ end the treatment, have it instead end the funding.  If the family came up with the money out of their own pocket, then the government and taxpayers wouldn’t have any room to complain.”

     

    “That’s no compromise, Crowepps. That’s discrimination against the poor.”

     

    It could be, just like it could be discrimination against the poor to not fund their abortions or to not provide the munificant $44 a month to fund that additional child.  It could also be, however, a realistic recognition that people who are getting free care may demand care way past reasonable limits because they aren’t the ones carrying the financial burden.  Instead it’s ‘society’, the taxpayer, who does so.

     

    It seems a little unreasonable to me to insist that women considering abortion should have to fund it entirely themselves because ‘the taxpayer’ doesn’t approve of that choice or to cut off infants from funding because ‘the taxpayer’ disapproves of illegitimacy and then to turn around and demand that ‘the taxpayer’ pony up the bucks to continue providing care to a patient with no hope of recovery because that family ‘deserves a free choice’.  Absolutely they deserve a choice, and I would never interfere with their making it, but I don’t see any reason why their choice is uniquely entitled to be free of the cost realities everyone else has to recognize.

     

    In order to be consistent either the taxpayer would pay for everything people feel entitled to without weighing in on the morality of their choices at all, or else ‘society’ could choose to pay for only those things which rationally promote the public welfare in general.  Sentimentality aside, keeping a comatose infant’s body alive artificially certainly has no value to the general public that I can see, no matter how important it is to the individual family.

  • progo35

    I thought I made it clear in my last post that I DON”T support society having any say in how many kids a woman has, even if she is on wellfare. I don’t actually disapprove of “illegitimacy” in the sense that I don’t think of any child as “illegitimate.” The only thing I don’t want to pay for is abortion. I just want no part of it. But I am happy to fund additional children or birth control or prenatale care, etc. I don’t think soceity should have a say in whether a woman has an aditional child. The thing that distinquishes abortion and cutting off medical care to someone is that both involve some sort of death. Yes, I know that not everyone thinks of the fetus as a person, but even if that is so, an entity is still being destroyed via the abortion procedure. Thus, people who do not want to particpate in that destruction decline tod do so, and I think that’s fine. What is not fine is for society to force someone into doing something that results in death or is designed to curb someone’s very existence, such as cutting off funding for medical care or an additional child.

  • jayn

    Um….

     

    I thought I made it clear in my last post that I DON”T support society having any say in how many kids a woman has, even if she is on wellfare.

     

    The only thing I don’t want to pay for is abortion.

     

    While I respect your opinion, these two statements don’t really go well together.  If you aren’t willing to pay for abortion, then you ARE having a say in how many children women have–it’s just towards them having more, not less.

     

    Otherwise, though, I agree with you.  Laws should only affect medical care in the case of ensuring that people have the ability to make their own decisions about it.

  • progo35

    “Otherwise, though, I agree with you.  Laws should only affect medical care in the case of ensuring that people have the ability to make their own decisions about it.”

     

    Right, and that is where I believe pro choice and pro life advocates can band together to stop abuses like futile care laws. We won’t ever agree on everything, that’s a fact. But there are many productive, good things we can do if we collaborate together, for women and humanity in general.

  • crowepps

    But we’re not talking about legislating your own particular views, but instead the goals of the ProLife legislators, who simultaneously want to end abortion and end support for the poor and leave families responsible for supporting the disabled themselves.  They don’t want to pay taxes to support people who are poor or disabled or finance women’s pregnancies.

     

    Certainly the conservative platform is that everybody should be ‘personally responsible’ to solve their own problems.  Remember when they wanted to get rid of Social Security altogether and mandate Individual Retirement Accounts for all instead?  I hope you realize that also would have meant there would have been no funds available to continue federal disability payments.

     

    “What is not fine is for society to force someone into doing something that results in death”

     

    I agree – that’s why I think abortions should remain legal.  Pregnancy can and does result in death for women and so do illegal abortions.  I think a person who is risking death should be able to make their own decisions about whether they’re willing to take those risks.

  • progo35

    That’s all very interesting, Crowepps, but the issue here is futile care laws, which violate fundamental tenets of pro life and pro choice philosophy, or, to put it another way, the conservative emphasis on life and the liberal emphasis on choice. We are not going to agree on abortion but we still need to join forces in fighting futile care laws that deprive born people of life and choice.

  • progo35

    That’s all very interesting, Crowepps, but the issue here is futile care laws, which violate fundamental tenets of pro life and pro choice philosophy, or, to put it another way, the conservative emphasis on life and the liberal emphasis on choice. We are not going to agree on abortion but we still need to join forces in fighting futile care laws that deprive born people of life and choice.

  • ahunt

    They don’t want to pay taxes to support people who are poor or disabled or finance women’s pregnancies.

     

    Silly crowepps…this is the responsibility of neighbors, and area churches and the local Comminity Chest. Because that works so well.

     

    No really.

  • crowepps

    The conservative concern about ‘life’ tends to end where they might have to dig in their pockets and pay taxes to pay for it, or weren’t you aware that one of the first, and harshest, ”futile care laws” in the USA was passed by a conservative government in Texas and signed into law by George Bush?  That law allows the hospital to stop further treatment for patients whose cases the doctors consider hopeless even if the family is paying for the care themselves.

     

    There’s an interesting review of the reasoning behind that law here:

    http://www.baylorhealth.edu/proceedings/13_2/13_2_fine.html

  • progo35

    I’m aware of that, Crowepps, and the hypocrisy disgusts me. That’s why I mentioned pro life and pro choice people as needing to be more consistent in fighting against this issue. I would like to remind you, also, that democrats in TX collaborated with Bush on this, and that Tim Kaine, a Democrat, has gone and done nothig about futile care laws in his state of Virginia.

     

  • progo35

    I’m aware of that, Crowepps, and the hypocrisy disgusts me. That’s why I mentioned pro life and pro choice people as needing to be more consistent in fighting against this issue. I would like to remind you, also, that democrats in TX collaborated with Bush on this, and that Tim Kaine, a Democrat, has gone and done nothig about futile care laws in his state of Virginia.

     

  • progo35

    I go against making blanket statements about any political party or person. For instance, I am conservative on the life issue but more liberal when it comes to things like the enviroment and gay rights. I am happy to pay taxes to help people, although I actually don’t currently make enough money to really pay taxes, at least in any significant way. I don’t like a lot of the things that both parties do, esp. when they are hypocritical. Remember that Time Kaine, governor of Virginia, did nothing to stop futile care laws while he was in office anymore than Rick Perry has. In MA, elders were stripped of their rights in 2007 and sent to nursing homes without so much as a court date, and that is a liberal state. And, like I’ve said before, let’s not forget people like Jocelyn Elders who said that abortion was good because it had resulted in less people with down syndrome being born.

  • crowepps

    Sure, because as in the past, the neighbors, area churches and local Community Chest know who deserves to be helped, and who are the feckless, lazy or immoral who don’t and should be allowed to beg or starve.  The children of the feckless, lazy and immoral can’t be helped either, of course, because watching them shiver and listening to their hungry cries is supposed to motivate the parents to ‘take personal responsibility’.

     

    For an example of how well this worked, check out “Birthright”, which I read over last weekend.

    http://www.guardian.co.uk/books/2010/feb/18/kidnapped-stevenson-true-story-annesley

    Or perhaps “Angela’s Ashes” by McCourt.

  • ahunt

    Pretty Much, Crowepps.

     

    We actually still have a Community Chest …but I can assure you that only the “deserving” are recipients of local largesse.

     

    The unworthy get to rely on the compassion of strangers.

  • progo35

    At first I thought the law was specifically targeting disabled poor people who couldn’t pay the bills, but then I realized that the scope was broader because it forbids care to continue even if the patient can pay for it. The point is that the law puts a value on disabled people’s lives and tends to victimize the most vulenerable. For instance, many (but not all) of the people victimized by the law have either been poor or have been racial minorities whereas the doctors making decisions about discontinuing care were white and affluent. I remember when I first heard of the law in the case of Emilio Gonzalez and thought back to a cartoon concerning abortion. The cartoon showed a doctor closing a clinic in a poverty stricken county saying to a client, “sorry, but the rich, white American president says you’ll keep the baby.” I felt that someone should create a cartoon with a hosptial ethics committee telling Catarina Gonzales, “Sorry, but the rich, white doctor says your son can’t have any more medical care.”

  • crowepps

    “the scope was broader because it forbids care to continue even if the patient can pay for it.”

    The idea behind these laws is that the purpose of medical treatment is to help the patient to recover, and that if recovery to the point of existing without the machines is not possible, then those types of medical treatment, with their attendent complications and difficulties, cease to be ‘treatment’ and edge into being actual harm to the patient.  I’m not educated enough on all the complications to understand entirely why this is true, but certainly a full code is physically traumatic for the patient, and I know they have a lot of problems with comatose patients being fed artifically through tubes developing infections at the insertion site.

     

    Progo, what do you think is the purpose of medical treatment in cases where there is no discernible higher brain function?

  • progo35

    The point, for me, is twofold

     

    1) Doctors are not gods and they are not always right. Moreover, as I’ve said before, “no discernible higher brain function” can mean many different things to different people. People use this term to describe everyone from a person who is brain dead to a person who has sustained a significant traumatic brain injury but still functions, much like an infant would. Thus, the capacity for rehabilitation is very difficult for even the best doctors to gauge.

    For example, do you remember the case of Haliegh Pouture, a child who sustained severe brain injuries when her adoptive parents beat her? Over the objections of her biological mother, MA social services acted with withdraw her feeding tube. Luckily, the day they were going to take it out, she showed signs of alertness and this was not done. Now she is in school and working with a speech therapist to correct some of the damage that was done via the beating. The doctors who said that she had no discernible higher brain function were wrong. She survived and is doing well.

     

    2) Getting back to the choice aspect-who are you or I or a human doctor to say what is futile and what is beneficial to someone in that state? If you really believe in choice, than you should support the parent’s choice to maintain life support/medical care for whatever reason they choose. That’s how it should work. The doctors can give their opinion on what is best, but it is up to the family to make the decision.

     

    For an example of how futile care undermines patient autonomy, see this answering machine message posted by the sister of Andrea Clark, who was one of the victims of Texas’ futile care law in 2006. This message, recorded by another person whose loved one was a victim of this policy, was used at a congressional hearing debating futile care:

    http://www.youtube.com/watch?v=qZ0HOq0qNi4

  • progo35

    I don’t know why my posts keep posting multiple times, but they do, so please see the post below.

  • progo35

    Update: baby Isaiah has succumbed to his condition after the parents made the decision to stop treatment. Note that if they did not seek legal injunction, that decision would not have been theirs to make. This way, they decided when the time was right for their child. It is tragic that they had to spend his last precious days  on earth fighting for their right to make that choice.