Euthanasia and Futile Care

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Euthanasia and "Futile Care"

Imagine visiting your 85-year-old mother in the hospital after she has a debilitating stroke. You find out that, in order to survive, she requires a feeding tube and antibiotics to fight an infection. She once told you that no matter what happened, she wants to live. But the doctor refuses further life-sustaining treatment. When you ask why, you are told, in effect, "The time has come for your mother to die. All we will provide is comfort care."

Sound far-fetched? It's not. It's already happening.

Just as doctors once hooked people up to machines against their will, now

many bioethicists advocate that doctors be permitted to refuse

life-sustaining treatment that a patient wants but that they deem "futile"

or "inappropriate."

Alarmingly, hospitals in California and throughout the country have begun

to implement these "futile-care" policies that state, in effect: "We

reserve the right to refuse service."

Medical and bioethics journals for several years kept up a drumbeat

advocating the implementation of medical futility policies that hospitals

-- for obvious reasons -- don't publicize. The mainstream news media have

generally ignored the threat.

As a consequence, members of the public and their elected representatives

remain in the dark as "futilitarians" become empowered to hand down

unilateral death sentences.

Indeed, futile-care policies are implemented so quietly that no one knows

their extent. No one has made a systematic study of how many patients'

lives have been lost or whether futile-care decisions were reached

according to hospital policies or the law.

The idea behind futile care goes like this: The patient wants life-

sustaining treatment; the physician does not believe the quality of the

patient's life justifies the costs to the health institution or the

physical and emotional burdens of care; therefore, the doctor is entitled

to refuse further treatment (other than comfort care) as "futile" or

"inappropriate."

Treatments withheld under this policy might include antibiotics to treat

infection, medicines for fever reduction, tube feeding and hydration,

kidney dialysis or ventilator support.

Of course, physicians have never been -- nor should they be -- required to

provide medical interventions that provide no medical benefit.

For example, if a patient demands chemotherapy to treat an ulcer, the

physician should refuse. Such a "treatment" would have no medical benefit.

But this kind of "physiological futility," as it is sometimes called, is

not what modern futile-care theory is all about.

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