Pushing Futile Care
I appreciate Wesley asking me to help out while he is vacationing. So here it goes...
Posted by Bobby Schindler
Although I agree with some of what Dr. Fisher says in regard to our failing health care system, his underlying premise about how to fix it should concern us all. The good doctor is clearly promoting the extremely dangerous futile care theory that Wesley often writes about. From the article:
"How death is approached by the medical community has been further complicated by a growing patient-rights movement and an undermining of physicians," he said. "Patients have been given more power to refuse appropriate therapy, and many have interpreted this change to mean that patients also have the right to insist on and receive inappropriate therapy."
Here Dr. Fisher argues why we need futile care.
"We ask families to make the decisions," he said. "We put the onus on the family to decide care. To me, that's a dereliction of duty." "Doctors provide patients with two things -- skills and judgment -- and judgment is by far the more important skill. Judgment comes from seeing hundreds of cases over a course of years," Fisher said. "A physician consults with a family and should present all the rational options. But at some point the doctor has to say when attempts at curative care are no longer a rational choice."
Once again we are seeing a major push from the medical community claiming that doctors should have the power to make final decisions regarding whether or not a patient should be provided care or even allowed continued care once treatment has begun.
One only has to think of Jesse Ramirez and Haleigh Poutre to recognize that giving doctor's full authority on these matters will do little to help "fix" our national health care problems. Unless you are part of the crowd that believes the solution to health care problems is to stop treatment to those who are sick, weak or otherwise vulnerable.


4 Comments:
Bobby : In a quick change of planes at Heathrow: Thanks for posting on this. The jig is up. The claim was always that it was "for the patient," but what futile care theory really is about is creating the principle that permits health care rationing and medical discrimination.
If extending life is not appropriate when that is what the patient wants, we are all in big trouble.
The Kalamazoo Gazette states: "Terry Schiavo case, in which the parents and husband of a woman in a persistent vegetative state had a long legal battle over whether or not to continue life-prolonging measures".
First, many or most "medical treatments" are "life-prolonging measures",whether it is an anti-biotic given to a non-disabled person for an ear infection, or a feeding tube placed in a child who is unable to swallow, but who is otherwise able to run, jump, play and learn alongside his peers. No one would argue (at least for the time being) the legitimatcy of these "life-prolonging measures".
Second, throughout this article the doctor is speaking about end of life decisions, but then he brings up Terri Schiavo, who was not in a terminal state - she had A significant physical and cognitive impairment, but she was not dying (unless you withheld food and water which would cause even a non-disabled person's death). So the impression I got from this article is three things.
1. If, after a purposed treatment, a person is not expected to contribute to society in the way the doctor determines as "meaningfull", then the doctor decides that this purposed treatment is "futile care", your civil rights are stripped and therefore your at the end of life.
2. I have the absolute right to refuse care, even when doctors think I will benefit from the treatment, but I have no right to say what I want if it costs money and the in the docors judgment it won't make me productive.
3. Doctors judgments are equal to God's and therefore are infaluable.
Thank you for your comments Renee. This attitude shift that has taken place within our medical community is frightening, and in my opinion, is going to get worse. Bobby Schindler
Since when is a medical degree synonomous with a proper ethical understanding? The study of medicine deals with the health of the body while ethical theory deal with the moral theory of right and wrong.
If an ethicist, not medically trained, practiced on a Doctor's patient the doctor would be outraged. How come doctor's some how feel they have a right to intrude into a discipline in which many are not particuliarly skilled? I would label that philosophical malpractice!
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