Futile care. Physicians should not be allowed to refuse to treat. Point.
Eighteen years after the era of Karen Ann Quinlan, the debate over futile care has shifted. Now some patients are asking for treatment that care givers believe to be useless. In virtually all cases of so-called futile care, the real disagreement is not over whether a treatment will produce an effect; it is over whether some agreed-on potential effect is of any value. An obvious reason to resist providing care believed to be futile is that is appears to consume scarce resources and therefore burden others. However, for care that affects the dying trajectory but appears to most of us to offer no benefit, the proper course is for society--not clinicians--to cut patients off. Under certain circumstances patients should have the right to receive life-prolonging care from their clinicians, provided it is equitable funded, even it the clinicians believe the care is futile and even if it violates their conscience to provide it. Society is not in a position to override a competent patient who prefers to live even if life prolongation is burdensome. For incompetent patients, if a clinician believes a treatment is actually hurting a patient significantly, he or she may appeal to a court to have it stopped. A society that forces people to die against their will produces more offense than one that forces healthcare providers to provide services that violate their conscience. And medical professionals have a social contract with society to control the use of medical, life-prolonging technologies.(ABSTRACT TRUNCATED AT 250 WORDS)
Kennedy Institute of Ethics, Georgetown University, Washington, DC.
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Veatch
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Spicer
D004992:Ethics, Medical; D005066:Euthanasia, Passive; D015276:Health Care Rationing; D006801:Humans; D033222:Judicial Role; D008020:Life Support Care / Q000592:standards*; D010344:Patient Advocacy; D026684:Personal Autonomy; D016079:Refusal to Treat; D040841:Resource Allocation; D018570:Risk Assessment; D013315:Stress, Psychological; D016896:Treatment Outcome; D014481:United States; D026712:Value of Life; D028761:Withholding Treatment