Coming Soon to a Hospital Near You

Yesterday, I told you the story of Grandpa Reitsema in The Netherlands whose doctor, without consulting the family, ordered nurses to withhold food and water and to administer overdoses of morphine. He didn't act out of malice. Instead, as he told the family, "I was just helping him out." This story may make you glad that you don't live in The Netherlands -- that is, until you realize that American medicine is headed in the same direction. According to Wesley Smith of the Discovery Institute, "futile-care" theory is "one of the most dangerous topics [under discussion] in contemporary bioethics." "Futile-care" holds that "when a physician believes the quality of a patient's life is too low to justify life-sustaining treatment, the doctor is entitled to refuse care," calling it "inappropriate." This judgment prevails over the patient's and family's wishes. As Smith puts it, "It is the equivalent of a hospital putting a sign over its entrance stating, 'We reserve the right to refuse service.'" It is important to understand the worldview that drives the "futile-care" theory. Now, no one believes that a doctor should be required to give a patient "physiologically futile" treatment -- prescribing useless therapies just because the patient may demand it. That's not what "futile-care" is about. It is about preventing treatment that does work, that is, treatment that prolongs life. In "futile-care" theory, "bioethicists and doctors unilaterally determine" which lives are worth prolonging. As Smith notes, in "futile-care" theory, what's regarded as futile isn't the treatment -- it's the patient. And it's not just dying patients. One "futile-care" advocate told Smith that he would deny an otherwise-healthy eighty-year-old woman a mammogram. What, the advocate argued, would be the point of treatment at her age if a problem was discovered? This should frighten us all because, above all, doctors are not infallible. People have recovered from conditions that doctors pronounced hopeless. Doctors aren't God -- but some are seeking to usurp His prerogatives. Even more frightening is that hospitals across the country are putting "futile-care" protocols in place. For instance, twenty-four of twenty-six California hospitals surveyed by the Cambridge Quarterly of Health Care Ethics adopted "futile-care" protocols. Bills have been introduced at the federal and state level to clarify the legality of these policies. It's easy, from a financial perspective, to understand the appeal of "futile-care" theory. Patients "requiring intensive or extended care" are money-losers for hospitals. The rising cost of health care, especially within an aging population, increases the pressure for other hospitals to follow suit. That's why Christians need to promote the sanctity of human life, because without a belief in the sanctity of life, all of our lives are potentially subject to a cost-benefit analysis. Only if we sustain the belief that life is sacred, created in the image of God, can we hope to prevail against the utilitarian calculus that is taking over the practice of medicine. Our embrace of the "culture of death" has left vulnerable people at the mercy of a stranger's subjective determination about the quality of their life. As in The Netherlands, our sick and elderly have good reason to tremble when, as Smith says, they hear someone say, "The doctor knows best." For further information: BreakPoint Commentary No. 030113, "Who Killed Grandpa?: 'Therapeutic' Death in a Dutch Nursing Home." Wesley J. Smith, "'Doc Knows Best'," National Review Online, 6 January 2003. Wesley J. Smith, "Killing Them Softly," National Review Online, 31 October 2000. Wesley J. Smith, The Culture of Death: The Assault on Medical Ethics in America (Encounter, 2002). Visit the International Task Force on Euthanasia and Assisted Suicide for more information. "Hospitals limit care to the dying," Waterloo-Cedar Falls Courier, 2 January 2003. Learn how you can make a difference in the culture with the "BreakPoint Culture of Life Packet." It includes the booklet "Building a Culture of Life: A Call to Respect Human Dignity in American Life" and a "BreakPoint This Week" special broadcast CD that includes an interview with Wilberforce Forum Fellow William Saunders, Human Rights Counsel and Senior Fellow in Human Life Studies for Family Research Council, along with a speech, "Bioethics and the Clash of Orthodoxies," by Dr. Robert George.


Chuck Colson


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