Doctor-Assisted Suicide and the Hospitals Bottom Line :: Euthanasia Physician Assisted Suicide

Euthanasia and the Hospitals' Bottom Line      Ã‚   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.