Tuesday, May 24, 2005

More On "No Right to Artificial Nutrition and Hydration"

"The most important bioethics litigation in the world today involves a 45-year-old Englishman, Leslie Burke... He isn't asking for very much. Burke has a progressive neurological disease that may one day deprive him of the ability to swallow. If that happens, Burke wants to receive food and water through a tube. Knowing that Britain's National Health Service (NHS) rations care, Burke sued to ensure that he will not be forced to endure death by dehydration against his wishes...

Why do Britain's medical establishment and government insist that Burke be denied a right to decide whether he receives tube-supplied food and water? It all boils down to two concepts that are increasingly intertwined in modern bioethics theory and practice. First is the so-called quality-of-life ethic that presumes to judge the worth of patients' lives according to their mental and physical capacities. Under this view, doctors or bioethicists may judge a life to be of such low quality that it is not worth extending, irrespective of the patient's wishes. The second issue is money -- an especially potent factor for England's increasingly strained socialized medical system."


Writing for the U.K. Weekly Standard and published online by CBS News on May 24, 2005,Wesley J. Smith, a lawyer and well-known spokesperson for the disabled presents his views of the two concepts he notes in the above excerpt. In his column, he expresses the conclusion that this case is even more important than the Terri Schiavo case in that he is concerned that our judicial system which is beginning to look to foreign decisions to guide to U.S. law, may use this British case as a source. ..Maurice.

p.s.- My view is that unless the artificial nutrition and hydration is physiologically futile, which it rarely is, whether this specific treatment is started or removed should be the patient's own decision after comparing the risks vs the quality of life to be gained. I think food and fluid decisions should be that of the patient and in all cases requests should be followed by the healthcare providers. There may be medical resistance to starting other life-supporting treatments if the physician finds the medical benefit to be nil, such as beginning dialysis in a terminal cancer patient. There may be special circumstances, such as temporary prolongation of life, which would make starting them appropriate. All life-supportive treatments should also be stopped at the patient's request. Beyond life-supportive treatments, other treatments requested by the patient should be subject to medical standards of practice.

No comments:

Post a Comment