--- David Hobby <[EMAIL PROTECTED]> wrote:
> Erik Reuter wrote:
[article quoted]
> > > "But that was before the bioethics movement
> largely abandoned the
> > > sanctity of life ethic for an express or
> implicit utilitarianism
> > > that views the value of human life through a
> distorting prism of
> > > "quality." That was before most bioethicists
> came to believe that
> > > health-care rationing should be imposed."
> >
> ...
> > I'd have no problem with him arguing about HOW to
> make the decisions
> > about who gets what medical resources, but he
> seems to be arguing,
> > against reality and common sense, that no decision
> needs to be made
> > at all, that medical resources are infinite. How
> can someone be so disconnected from reality?
>
> By looking at it just from a selfish emotional
> viewpoint? If one has a loved one in danger of
>death, one wants to do everything possible to save
>them. Ages ago, when "everything possible"
> didn't include as much, this made sense.
> I'm sure a lot of people will just respond to > the
article at an emotional level, and agree. But >it is
irresponsible to
> advance such an irrational argument.
Doctors and nurses have struggled for years with the
question of futile care. "Quality vs. quantity" is
not some interesting concept, but snaps in your face
(and nose) at any neurological ICU, PICU or nursing
home.
In the past, decisions were often made by one
individual, acting in what they thought was the best
interest of the family/patient; ethics comittees,
which have been around at many teaching hospitals
since the 80s, are an attempt to remove that power and
responsibility from a single person. Whether such
committees are a step towards greater transparency and
accountability, or towards 'star chamber' style
authoritarianism depends - like any governing body -
on the rules/articles of its foundation and upon the
integrity of most of the persons comprising it.
One facet of taking care of critically/terminally ill
patients has been to help the family know that it is
alright to let go, to accept that Mama or Papa is
*dying*, and all we can do is prolong that process -
not bring them back to a life. [The need for empathy
and compassion are part of what makes medicine, for
many who practice, a 'calling.']
And Erik's point about limited resources is quite
valid, as we don't live on a Federation starship; so
far Americans have not been willing to deal with the
reality of rationed healthcare. (I can't remember if
it was on-list or Brin-chat that we discussed two- or
three- tier systems...Dee?)
Debbi
"But yield who will to their separation,
My object in living is to unite
My avocation and vocation,
As my two eyes make one in sight."
Robert Frost, 'Two Tramps in Mud Time'
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