Who Decides the Harm in “Do No Harm?”
By Wesley J. Smith
Editor’s Note: In his excellent piece Wesley Smith sounds the alarm about a Canadian board that typifies the push to deny life-saving medical treatment against the will of patients and families on both sides of the border. National Right to Life is more pessimistic than he is about the “rarity” of these cases – see ww.nrlc.org/uploads/medethics/WillYourAdvanceDirectiveBeFollowed.pdf. And in our view the circumstances in which health care providers should be able to coerce denial of treatment should be limited to physiological futility – only when, in reasonable medical judgment, withholding or withdrawal of the desired treatment would neither cause nor hasten the patient’s death.

Julie
Cheah holds a photo of her late husband, Mann Kee Li. Cheah, who went
to court to dispute a “do not resuscitate” code on his hospital chart,
says she was not told of the Ontario panel that mediates in such cases.
RICHARD LAUTENS / TORONTO STAR
RICHARD LAUTENS / TORONTO STAR
Bioethicists and some doctors believe that they get to decide what constitutes “harm.” Thus, if a patient is unlikely to recover or ever lead a “meaningful” life, they insist on being able to stop wanted treatment.
Religion is also a large factor in many of these situations. The secularist view sees suffering as the worst harm. Many religions, particularly more traditional approaches to Catholicism, Islam, and Judaism, death. Thus, forcing treatment to cease is often viewed as disrespecting freedom of religion.
At the same time, many futilitiarians believe in judging “harm” on a the macro level. They look beyond the patient to perceived emotional harm to the family–and the morale of the reluctant medical team–as well as financial harm to society by “investing” resources on the patient supposedly more wisely spent elsewhere.
So who gets to decide the meaning of “harm” in a particular situation–the patient/family or the technocrats?
Canada has established a bureaucratic board to make these decisions when doctors/bioethicists and patients/families disagree. From the Toronto Star story:
In Ontario, intractable,
life-and-death disputes between physicians and patients’ families
sometimes end up before a unique provincial body charged with wading
into complex issues of medicine, ethics and faith. The little-known
Consent and Capacity Board (CCB) — the only one of its kind in North
America, perhaps anywhere — is a working laboratory for the most
pressing issue facing Canada’s healthcare system: the end of life.
When a physician’s treatment proposal
is challenged by a family member whose loved one can no longer
communicate their wishes, doctors can make an application to the CCB.
The Board then convenes a hearing within seven days, often in hospital
board rooms, headed by a lawyer, a public member and a medical
professional, typically a psychiatrist.
The panel’s job is a mix of legal
arguments and character analysis. It must ultimately determine an
incapacitated patient’s “prior wishes” or “best interests.” The panel
must then issue a binding order within 24 hours of the hearing’s
conclusion — a remarkably fast and economical process relative to the
courts.
It seems to me that these futility cases are so relatively few and far between that coercion should rarely–if ever–be used.These are subjective decisions. Establishing bureaucratic boards would sow mistrust for the system and validate the concept of “death panels.”
And talk about the potential for abuse of power. Why should strangers to the patient be given so much authority, in effect, empowered to impose their values over those of the family?
No. Education and continual mediation should be the watchword. Doctors should be brutally frank about the consequences of continuing care. But barring very rare circumstances, the patient/family should have the final word.
Source: NRLC News
I’m going to say something some may find shocking.
To
put it mildly, a headline that read only, “Pope’s Meeting With the
Elderly in St. Peter’s Square” missed all that was special Sunday in a
gathering Pope Francis (and his predecessor Pope Emeritus Benedict XVI)
had with elderly from around the world.
As
we have documented in exhaustive detail, one wing of the Abortion
Movement (and not an insignificant one) has become militantly insistent
that women have the “right” to self-abort. And never you mind about
state laws, the incredible dangers of buying powerful chemical
abortifacients sight unseen, and their own version of “mission creep”:
abortions performed well into the second trimester, if not beyond.


It
is a free country so a Drake University professor of English and
Women’s and Gender Studies was welcome to hammer the student newspaper
(the Times-Delphic) for the audacity of running an ad from AGAPE
Pregnancy Center in Des Moines, Iowa.





Thursday
marked the 34th anniversary of the enforcement of China’s brutal
One-Child Policy, a policy which results in the loss of millions of
unborn children and inflicts horrific abuse upon women. The cruel policy
– which makes siblings illegal – has been implemented through coercion
and violence and resulted in a dramatic gender imbalance in the
population.

In
Switzerland, the numbers of people traveling from abroad to die are
growing dramatically. Even more disturbing is the fact that the reasons
they cite in seeking suicide are growing beyond inevitably terminal
illness to include traditionally manageable conditions. In a New
Scientist magazine article, “Non-fatal diseases increasingly drive
assisted suicide,” Penny Sarchet reports
While
promoting access to abortion as a “reproductive right” at the United
Nations and advocating for the elimination of pro-life laws, Ipas is
also busy creating illegal abortion networks in Mexico. The work is
based on an “accompaniment model” which pairs abortion seeking women
with volunteers who guide a woman through the self-induced or
do-it-yourself (DIY) abortion and is the subject of the documentary
“Accompaniment” by Ipas partner Las Libres.
