Bioethics Discussion Blog: More On "No Right to Artificial Nutrition and Hydration"

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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.

5 Comments:

At Wednesday, May 25, 2005 4:06:00 AM, Blogger james gaulte said...

Let me raise the following as a question for discussion. What is the difference between what the NHS proposes and what took place under the Nazi T4 program other than the obvious difference between passively letting someone die and the active killing that took place in Germany for those whose "lives were not fit to live"?

 
At Wednesday, May 25, 2005 8:25:00 AM, Blogger Maurice Bernstein, M.D. said...

Presumably the main difference was that the Nazi regime's goal was for cleansing out the weak from the population and the NHS's goal is to save money. I am sure that if a weakened patient wanted to pay fully for all the treatments including food and fluid, that decision would be gratefully acceptad by the NHS. Does anyone think that the NHS motivation would be different such as the alleged view of the ex-Governor Lamm of Colorado that the elderly have a duty to die? ..Maurice.

 
At Wednesday, June 01, 2005 11:30:00 AM, Anonymous Anonymous said...

Some of this same posting from Wesley Smith is excerpted on the blog economicsandliberty.blogspot.blog with comments about government involvement in decisions making. You may want to check it out for a slightly different approach from the perspective of economics and personal liberty.

 
At Tuesday, June 07, 2005 7:16:00 PM, Anonymous Anonymous said...

This is an uncommon situation, and I don't think there is much to learn from it. More of a commentary on the lack of trust that the British have in their own NHS.

Even this kind of case has it limits...what if this gentleman were to, by some miraculous means, live long after there was any ability to have any interaction whatsoever with the outside world? What if there were thousands or tens of thousands of people living like that?
Ultimately, there are societal concerns that will have their way in such situations.

 
At Wednesday, September 07, 2005 6:43:00 PM, Anonymous Rob Wright said...

By Rob Wright
The Opinion - www.theopinion.co.uk

I have made a reference to your blog on my web site, I am concerned that stories similar to this one are going un-noticed in the UK.

Please support the site by adding your comments to the stories.

Thank you.

Rob Wright.

 

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