Wednesday, January 27, 2010

The Two Faces of a Life or Death Dilemma

Lisa Priest
Globe & Mail
January 27, 2010

The two cases raise identical questions: Who decides when medical treatment is futile? When does life-saving care turn into a superhuman effort to prolong death?

Link to article here.



Blogger Practical Bioethics said...

I can not help being a bit concerned: That what seems to be a push for euthanasia for "quality of life" cost control, and convenience may be the opposite side of abortion which was and is promoted for the same three basic reasons.

I saw where a Belgian politician objected to the appointment of the new head of the Catholic Church in Belgium for, among other things, that Archbishop's opposition to abortion *and euthanasia* as if the two were opposite sides of the same coin.

While the Catholic Church and some theologically and socially conservative Protestant Churches are opposed to both along with what has been called the "culture of death" (correctly, in my opinion,) theologically and socially liberal (revisionist) Protestant Churches seem to be promoting it for what seems to some (including myself) to be a perversion of the historical positions of Christianity against abortion and euthanasia as well as of Medical Ethics ("Do no harm.")

Just some thoughts.

Irl GLadfelter

Thursday, January 28, 2010  
Blogger Maurice Bernstein, M.D. said...

The futility of medical treatment is set by both the physician (physiologic futility) and the patient (goal futility). If the treatment is anticipated or seen by the physician as not a technique to correct the immediate or longer term symptoms or disease process then the treatment is physiologically futile. If the patient finds that even if the treatment could immediately and in the future keep the patient alive, that the treatment would not restore the patient to the life which was desired by the patient then the treatment is goal futile.

Therefore, as you see, if the setting of futility is the question, it requires the input of both the physician and patient. If the patient's condition is such that he or she is unable to express and communicate their goals at the time the decision is to be made, then it may require a surrogate who has known the patient's expressions in the past to make that decision. If there is no such surrogate and the patient can't communicate, then the physician with support from an ethics committee has to make the goal decision based on what the average person might decide as a goal under the same circumstances, a so-called "patient best interest" decision. And that is the least satisfactory way to set futility. ..Maurice.

Sunday, January 31, 2010  

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