Dr.'s decide if you receive life-sustaining med. treatment

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January 6, 2003, 9:00 a.m.
“Doc Knows Best”
It’ll be too late for you, if he’s wrong.
By Wesley J. Smith

Who should have the right to decide whether you receive life-sustaining medical during a critical or terminal illness? Most would say with great confidence, "Me. Or, if I am unable to decide, then my family."
That should be true. Indeed, it used to be true. But in a growing number of hospitals, your right-to-decide is being taken away from you (or your family) by bioethicists and members of the medical intelligentsia who believe that their values and priorities should count more than yours when determining whether you shall receive wanted medical treatment. To put it bluntly, even if you want to live, even if you want medical treatment to enable you to fight for your life, you may be told that the hospital reserves the right to refuse service.
I wonder how many people are aware of this? I would imagine that only those who have run afowl of it are. Any comment?

http://www.nationalreview.com/comment/comment-smith010603.asp

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Sadly, we are in a world of finite resources, with demand often exceeding supply. That supply is going to be rationed - but how? By the patient? This is going to come down to the wealthy or best insured receiving the best, or at least most expensive treatment. If there is some alternative other than rationing by money or a combination of bioethicists and medical intelligensia, I would like to hear it. Your patient simply demanding what is not available to all patients in the same situation is not a solution. Think organ transplants if an extreme example of finite resources is needed.

Love your provocative questions au, and I'm glad to see they are generating some disucssion

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au1929- I know, from personal experience. I had contracted a form of cancer that was considered terminal. The cancer centers were just beginning to use bone marrow transplants for my type of the disease. The problem was, that there was a cut off age that the hospital would perform the procedure, and I had just passed that age.

In my case, I was lucky. My MD found a hospital that WOULD perform the procedure on me, or we would not be having this discussion today.

I had always suspected that the age cutoff was because of political reasons. The hospital wanted positive outcomes for their statistics, and younger people were more likely to survive a procedure which, at that time, was quite rigorous.

I think many medical decisions made by hospitals are made for monetary, funding, time constraints and cost/benefit considerations. It is a very complex ethical, moral, and practical question.

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Following the admission of any patient and prior to any invasive procedure, the patient will be given a Consent form. If you sign this form, you agree to accept responsibility for the consequences of the procedure...good or bad.

While a patient in a hospital, you must determine whether you WANT to be put on life sustaining equipment and whether you want to be resuscitated should your heart fail. You are the determinant of your fate, not the hospital. If it's to be the hospital, there'll be no PAUPER lawyers practicing heath law.

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New Haven
What you say is correct but that is not what the post is referring to.

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Different laws for different states. In my state, need an Advance Directive - there are at least 3 parts that individually need to be signed. A trusted friend or family memeber needs to be assigned in a Durable Power of Attorney. Make sure these are on file with Doctors and Hospitals.

Then, when the time comes, if one person who is a close family member says no - save them, then that overrules directives and Powers of Attorney. At this time, no outside entity can stop the procedure or lack thereof. The one catch is a clause that states that the patient will be made comfortable. Of course, we would all want this - it is for the reduction of pain. However, it may be a matter of interpretation. Hospitals/Doctors will always rule on the side of liability insurance.

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BillW

Suggest you re read the link. Both you and NH are not addressing the subject of the post.

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Well strap me down and suck my blood. I "read" it twice and decided that this is the answer you wanted. BTW, I don't really believe this is that new. The HMO's have been doing this for years - a lot of the ethics is the "ethics of the almighty $" me thinks!

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BillW:

What about the wishes previously express by the patient? Aren't these in writing and signed by patient of closest relative?

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What do you bet that these bioethical rules don't apply to lawyers?

Do the hospitals really want giant lawsuits?

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New Haven

Please note.

Quote:

That should be true. Indeed, it used to be true. But in a growing number of hospitals, your right-to-decide is being taken away from you (or your family) by bioethicists and members of the medical intelligentsia who believe that their values and priorities should count more than yours when determining whether you shall receive wanted medical treatment. To put it bluntly, even if you want to live, even if you want medical treatment to enable you to fight for your life, you may be told that the hospital reserves the right to refuse service.

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Caveat- I am throwing this idea out as a "devil's advocate", so please don't jump all over me.

Many people are upset, because they believe that they (or their families) have the right to decide what treatment they want.

What about the rights of the doctors and the hospitals? Do they have any rights in determining whether they wish to offer a particular procedure to a patient? Does a doctor have the right to say that he does not believe that a certain procedure is appropriate (for whatever reason) for a particular patient, and he does not want to spend his time working on what he perceives as a needless, or useless procedure? Or maybe he just doesn't want to do it.

Think about it!

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Phoenix:

In many hospitals MDs do play a role in determing whether a specific procedure would be appropriate for a specific patient. For instance, a 90 yr old man had prostate cancer. The patient's family wanted surgery with follow-up care. The surgeons in this specific hospital refused to operate on
a man of that age. The surgery etc could easily kill the man before the prostate cancer or even...natural death.

That's sensible doctoring. However....there are MDs who would do the surgery in a different hospital and charge a fee($$).

Before going to a hospital for surgery, if you're afraid of dying due to neglect by the medical staff, best for you to consult a lawyer, who can work up the appropriate paperwork to ensure you are not treated in an unethical and nonprofessional manner.

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New Haven
The last thing anyone thinks of is going to a lawyer when faced with a life threatening condition. Further, it is very difficult to do when hooked up with tubes and wires.

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New Haven- I also think that people need to become more knowledgable in their selection of doctors and hospitals. I think that if a person has a serious medical condition, he needs to have an understanding of the attitudes of a particular doctor. I think that some people do more research in finding a car dealer than providers of their medical care!

I have an elderly friend, who needed serious surgery recently. Because of her age, and multiple medical problems, her regular cardiac surgeon refused to do it. Thank goodness that she has a very intelligent daughter who is a strong advocate for her. She researched and found a wonderful doctor who performed the surgery, and my friend is fine now.

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Some of my best friends are Health Law lawyers. They would come to my side if I needed them. Rolling Eyes

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Phoenix:

I agree with you. Research your condition and then search for an MD.
Razz

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Dr.'s decide if you receive life-sustaining med. treatment

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