Features

When all's futile

"When all's futile" Continued...

Issue: "An evolving debate," May 21, 2005

Today, medical literature treats futile-care theory as unworkable in practice. But the theory lives on in disguise as the literature remains rife with discussions of medical "justice" (which used to mean nondiscrimination on the basis of race or ability to pay, but now means giving preferential care to those more likely to recover), "quality of life," and "personhood."

In a 2003 study published in the Journal of Paediatrics and Child Health, David Isaacs of the Children's Hospital of Westmead in Australia concluded that "a person-centred approach [to brain death] can identify some humans, such as those in a persistent vegetative state, whose continued existence has lost value and whose lives we are not obliged to sustain."

A 2003 study by Swiss doctors found an unacceptable "cost per survivor" among intensive-care patients with hospital stays of longer than seven days. "Resource use per patient surviving the ICU was approximately 10-fold higher in patients with [a] long-term stay. . . . Further, quality of life has also to be taken into account. . . . To justify resource use for those with an extremely long stay, more needs to be known about the outcome of these individuals."

A 2005 study published in Ethics in Cardiopulmonary Medicine argues that it is not always necessary to allow a mentally competent but sedated terminal patient to participate in end-of-life decision-making. It is not always compassionate, argues author Mark R. Tonelli, to wake them up only to tell them they are dying.

When pernicious material in "the literature" reaches critical mass, the effect can be disastrous, said Christian Medical Association's Dr. Rudd, as has happened with "scientific" discussions of homosexuality, pedophilia, and assisted suicide, issues European researchers systematically destigmatized before sending them West.

American medicine now teeters on the edge of a dangerous utilitarian ethic: "Medicine has moved away from a covenant relationship to more of a contractual relationship that hinges on issues of economics and burdens on the health-care system," Dr. Rudd said. "Any life-honoring value system we still have might succumb to economic pressure. We have to shore up the value system now so that won't happen."

Comments

You must be a WORLD member to post comments.

    Keep Reading

     

    Good credit

    Competency-based programs offer college credentials without the debilitating cost

     

    Soaring sounds

    Three recent albums highlight the aesthetic and emotional range…

     

    Numbers matter

    Understaffing the U.S. effort in Iraq from the beginning…

    Advertisement