Euthanasia and the Hospitals' Bottom Line
An important factor in debates over health care and treatment strategies is the issue of cost. It is tremendously expensive to provide the state-of-the-art care that the modern hospital offers. Concerns about where the money will come from to care for elderly citizens appear to be making the case for "mercy killing" even more compelling. Under financial pressure, hospitals are exercising their right to deny such expensive healthcare to the aged or seriously ill.
We reserve the right to refuse service: Most people have seen these signs at restaurants and retail shops. But now, metaphorically, some hospitals are hanging such notices over their entryways by promulgating "futile care" protocols that grant doctors the right to say no to wanted life-extending medical treatment to patients whose lives they consider lacking in sufficient quality to justify the cost of care.
Unnoticed by the mainstream press, a disturbing study published in the Fall 2000 issue of the Cambridge Quarterly of Health Care Ethics reveals how far the futile-care movement, in reality the opening salvo in a planned campaign among medical elites to impose health-care rationing upon us, has already advanced. The authors reviewed futility policies currently in effect in 26 California hospitals. Of these, only one policy provided that "doctors should act to support the patient's life" when life-extending care is wanted. All but two of the hospital policies defined circumstances in which treatments should be considered nonobligatory even if requested by the patient or patient representative. In other words, 24 of the 26 hospitals permit doctors to unilaterally deny wanted life-supporting care.
How is such medical abandonment justified? Advocates of futile-care theory cleverly shift the focus away from the physiological effect provided to the patient and toward whether the patient has the "potential for appreciating the benefit of the treatment." Thus, the Cambridge Quarterly reports that 12 of the 26 hospitals surveyed prohibit treating people diagnosed with permanent unconsciousness (other than comfort care) based on these patients' supposed inability to know they are being treated. Never mind that several medical studies demonstrate that this condition is often wrongly diagnosed (40 percent misdiagnosis according to one British report). And never mind that such patients sometimes awaken unexpectedly, as recent headlines attest.
What is most disturbing is that these policies, if enforced, would prevent profoundly brain-damaged and dementia patients from receiving tube-supplied food and water because such care is considered medical treatment.
Diane: A Case of Physician Assisted Suicide. Diane was a patient of Dr. Timothy Quill, who was diagnosed with acute myelomonocytic leukemia. Diane overcame alcoholism and had vaginal cancer in her youth. She had been under his care for a period of 8 years, during which an intimate doctor-patient bond had been established.
Braddok III Clarence H. MD MPH .” Physician aid-in-dying: Ethical topics in medicine” n.d University of Washington school of medicinestate death with dignity act” N.p n.d University of Washington department of bioethics and humanities 2009 web 24 March 2012
Before, there were no breakthroughs with the opportunity of saving lives. Innovations in medical technology made contributions to correct abnormal heartbeats and save lives by using a defibrillator and modern respirator. Who would know that the rapid discoveries would include successfully giving patients surgical transplants? Furthermore, President Lyndon Johnson implemented an executive policy requiring the usage of medical response trauma teams. Since 1976, this executive order has allowed the widespread use of CPR, and organizations like the American Red Cross and the American Heart Association were founded. “About 6.4 million people now survive angina chest pain each year, while an additional 700,000 people survive a heart attack each year (pg. 15 of Last Rights) Despite these remarkable breakthroughs that help those badly injured, the law becomes vague and allows more opportunities for misinterpretation on defining death. As a result, this could be advantageously used against the best interest of others and the government. “This ten-year mishmash of laws is what led the previously mentioned President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, established by an act of Congress in 1978 , to tackle the first task of defining death.” (pg. 81). The President’s Commission forced the U.S Supreme Court and
The ongoing controversy about Physician assisted suicides is an ongoing battle among physicians, patients and court systems. The question of whether or not individuals have the “right” to choose death over suffering in their final days or hours of life continues to be contested. On one side you have the physicians and the Hippocratic Oath they took to save lives; on the other you have the patients’ right to make life choices, even if that means to choose death to end suffering. The ultimate question “is it ethical for a physician to agree to assisted suicides and is it ethical for a patient to request assisted suicide?
Did you know, about 57% of physicians today have received a request for physician assisted suicide due to suffering from a terminally ill patient. Suffering has always been a part of human existence, and these requests have been occurring since medicine has been around. Moreover, there are two principles that all organized medicine agree upon. The first one is physicians have a responsibility to relieve pain and suffering of dying patients in their care. The second one is physicians must respect patients’ competent decisions to decline life-sustaining treatment. Basically, these principles state the patients over the age of 18 that are mentally stable have the right to choose to end their life if they are suffering from pain. As of right now, Oregon, Washington, and Vermont have legalized physician assisted suicide through legislation. Montana has legalized it via court ruling. The first Death with Dignity Act (DWDA) became effective in Oregon in 1997. Washington and Vermont later passed this act in 2009, and Montana passed the Rights of the Terminally Ill Act in 2008. One concern with physician assisted suicide is confusion of the patient’s wishes. To get rid of any confusion and provide evidence in case someone becomes terminally ill, people should make an advanced care plan. The two main lethal drugs that are used during physician assisted suicide are secobarbital and pentobarbital. Appropriate reporting is necessary when distributing these drugs and performing the suicide in order to publish an analysis. Studies found a large number of people accepted this procedure under certain circumstances; therefore, physician assisted suicide should be legal in the United States because terminally ill patients over the age of 18 that are...
Social researchers, psychological researchers and criminological researchers alike have all applied the MacDonald triad theory to explain violent crime against humans. The triad theory simply uses three main variables, enuresis, pyromania, and animal cruelty during childhood to explain aggression that graduates to violent crimes against humans in adulthood. This research only looks at methods of animal cruelty used, and age of onset abuse. By identifying animal cruelty in childhood and adolescent children findings can be used as an indicator of adult violence and in turn develop the grounds for intervention and prevention. This research is replicated from studies done primarily by Hensley and Tallichet. In the early 1990’s Hensley and Tallichet researched and examined different aspects of animal cruelty and wrote several articles based on the same sample taken from inmates surveyed at both a medium and maximum security prisons in a southern state. According to Tallichet & Hensley (2008), the assertion that youthful animal abusers graduate to later aggression against humans, known as the “graduation hypothesis,” has become more commonly accepted by clinicians, social scientist, law enforcement, and animal advocates alike.
In Ben Jarashow’s Journey Into the Deaf World, he explained Deaf culture and how it feels to be deaf within the world of those who hear. People who are born deaf have a loss of what is commonly viewed as the most important sense, hearing. This leaves them with four senses instead of five; most important sense now being sight followed by touch. In return, this means that a language must be developed that is based heavily on sight. In the United States, it was not until 1960 that American Sign Language (ASL) was recognized as its own language.
Emilio is terminally ill and is under the care of the Children’s Hospital in Texas. He is placed on life support by a respirator and is given pills causing the child to spend majority of his time in the pediatric intensive care unit unconscious. Showing no signs of improvement, the physician has requested the parents look for another hospital willing to continue aiding Emilio within a period of 10 days. Under the Texas “futile-care” law, the hospital’s ethics committee can, “declare the care of a terminally ill patient to be of no benefit,” allowing them to terminate care after a given time period. (Moreno, Sylvia. Case Puts Futile-Treatment Law Under a Microscope.
In the United States today, approximately 4500 children are born deaf each year, and numerous other individuals suffer injuries or illnesses that can cause partial or total loss of hearing, making them the largest “disability” segment in the country. Although, those in the medical field focus solely on the medical aspects of hearing loss and deafness, members of the deaf community find this unwarranted focus limiting and restrictive; because of its failure to adequately delineate the sociological aspects and implications of the deaf and their culture. Present day members of deaf culture reject classifications such as “deaf mute” or “deaf and dumb”, as marginalizing them because of their allusions to a presumed disability. (Edwards, 2012, p. 26-30)
The disparity between the Deaf and hearing is based around ableism, or a newer notion, Audism. Audism is the notion that those that can hear are superior. (Oberholtzer, 2009) Like most that are viewed as inferior, the Deaf are often looked at as lesser compared to those of the hearing community and labeled as disabled, even if they themselves do not view their deafness as a disability. Many of Deaf community members are able to hear and speak well enough to communicate with hearing people but still chose to identify with the Deaf community rather than in the hearing world. (Harlan, 1996) One’s involvement does not center around their hearing
How are deaf individuals treated by everyday “normal” individuals? While some of those who are hearing do their best to understand the Deaf Community and learn ASL, most people who interact with deaf people, particularly kids, try to teach them how to speak. They don’t realise that it’s hard to speak a language that they’ve never heard. Also, lip-reading is seen as a savior to deaf people in the eyes of the hearing. But as deaf people cannot hear, they do not know how words are pronounced, and most words are mouthed the same, so honestly it’s just a guess as to what that person is
Bahan, Ben. Hoffmeister, Robert. Lane, Harlan. A Journey into the Deaf World. USA: Dawn Sign Press.
Today, medical interventions have made it possible to save or prolong lives, but should the process of dying be left to nature? (Brogden, 2001). Phrases such as, “killing is always considered murder,” and “while life is present, so is hope” are not enough to contract with the present medical knowledge in the Canadian health care system, which is proficient of giving injured patients a chance to live, which in the past would not have been possible (Brogden, 2001). According to Brogden, a number of economic and ethical questions arise concerning the increasing elderly population. This is the reason why the Canadian society ought to endeavor to come to a decision on what is right and ethical when it comes to facing death. Uhlmann (1998) mentions that individuals’ attitudes towards euthanasia differ. From a utilitarianism point of view – holding that an action is judged as good or bad in relation to the consequence, outcome, or end result that is derived from it, and people choosing actions that will, in a given circumstance, increase the overall good (Lum, 2010) - euthanasia could become a means of health care cost containment, and also, with specific safeguards and in certain circumstances the taking of a human life is merciful and that all of us are entitled to end our lives when we see fit.
Resources have always been inadequate for food, economics and healthcare and all scarce resources are rationed in one way or another. Healthcare resources can be in the forms of medicine, machinery, expensive treatment and organ transplantation. For decades, allocation of healthcare resources in an equitable manner has always been the subject of debate, concern and analysis, yet the issue has persistently resisted resolution. Scarcity of resources for healthcare and issue of allocation is permanent and inescapable (Harris, “Deciding between Patients”). Scarcity can be defined in general, in emergency and in crises as well as shortage of certain kind of treatment, medicine or organs. As a result of scarcity of resources, and some people may be left untreated or die when certain patients are prioritized and intention of is that everyone will ultimately be treated (Harris, 2009: 335). Allocation of limited resources is an ethical issue since it is vital to address the question of justice and making fair decisions. Ethical judgments and concerns are part of daily choice in allocation of health resources and also to ensure these resources are allocated in a fair and just way. This paper will explore how QALYs, ageism and responsibility in particular influence the allocation of healthcare resources in general through the lens of justice, equity, social worth, fairness, and deservingness.
Should a patient have the right to ask for a physician’s help to end his or her life? This question has raised great controversy for many years. The legalization of physician assisted suicide or active euthanasia is a complex issue and both sides have strong arguments. Supporters of active euthanasia often argue that active euthanasia is a good death, painless, quick, and ultimately is the patient’s choice. While it is understandable, though heart-rending, why a patient that is in severe pain and suffering that is incurable would choose euthanasia, it still does not outweigh the potential negative effects that the legalization of euthanasia may have. Active euthanasia should not be legalized because