In the News: To Euthanize a Person

The magic of Twitter alerted me to Global News’s live blog on euthanizing severely disabled children for reasons of suffering. The panel was stacked in favour thereof, featuring Robert Latimer, a mother of two severely disabled sons, and ethicist Arthur Schafer. As I scrolled through the discussion, I was able to pick up the core of Schafer’s stance:

I’m sure, Mary, that doctors sometimes deliberately hasten the deaths of their dying/suffering patients in Canada. Some have told me this personally. But no one admits it publicly because our law would convict them and sentence them to life imprisonment. So the decisions are made without safeguards, in the dark. I prefer the honesty, openness and safeguards of other societies. -Arthur Schafer

I firmly believe that the American system is broken. I believe there should be greater access to basic health care. I am grieved and outraged to hear of friends denied those basic needs over insurance technicalities, financial situation or an existing condition that desperately needs medical treatment.

But the Canadian system is broken too. I notice the difference because it’s not equal access for all. Dental is not covered by government health insurance; unlike large swaths of the population, we are heavily insured through my husband’s work. And the quality of care and access to options is on a whole other order of magnitude through those private providers.

Does it make it okay if the rich can afford what the poor cannot? No. But neither does that make it acceptable to create a system where compromises in care delivery, the bureaucracy of funding, and lack of needful literacy in navigating that bureaucracy create a paucity of treatment.

After the last year of strange health troubles and constant diagnostic waits of up to 3 months (symptoms? What symptoms, we’re on to the next strange thing now) my trust is significantly diminished.

And there’s not a single thing my front-line providers can do except try to navigate the system themselves. If they could do better, they would. Or so I want to believe.

In Ontario, the College of Physicians permits the doctor to withhold or withdraw treatment WITHOUT consent if he/she deems treatment to offer “no permanent benefit” A feeding tube is considered treatment. -Mary

Treating the patient as the problem to be removed from the equation is not doing better. This assumes a rightness to medical judgment that is just not true of human beings–and doctors, too, are fallibly human.

Not all of the disabled people here are Autistics – I have CP, just like Tracy Latimer. And that scares me. Because how long is it before someone decides I don’t have the right to live either? -Cara Liebowitz

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7 comments

  1. Euthanasia is just one of many reasons why universal healthcare scares the hell out of me. And about the US system being broken–yes, it certainly is. However, I always hear that basic healthcare is denied to poor people, but I’ve yet to witness this. Hospitals must treat all patients, regardless of ability to pay. So must EMTs. I’ve never lived in a community that didn’t have multiple free/low cost clinics. Of course, the US is an enormous country. So, who knows? Good post, anyway.

    1. I’ve had several acquaintances who’ve dealt with refusal of care. It tends to be related to existing health conditions, not emergent situations. They’re trying to prevent landing in the ER and trying to get a family doctor, and that’s where they’re getting turned away. Health maintenance seems to be the problem. It’s really hard to walk in for something like a severe allergy that would cause time off work, when one isn’t having an immediate attack of it–yet it’s completely debilitating to the family if an income provider doesn’t have preventative measures available.

      I suspect the issue involved is system literacy, many times, too. We have the same problem here–we have a relative who works for Manitoba Health and knows how to navigate the technicalities, how to talk to people at each desk so that they respond (and accurately) to the situation. It’s amazing how much of a difference it makes to be familiar with the unspoken rules of how things are done. Those unspoken rules keep things functioning in a large workplace, they’re part of the logistics, but they’re unintelligible to outsiders.

      And yeah, it was rather terrifying seeing how many people in the live chat brought up the value of human life in terms of dollars involved. “This disabled child has depleted our retirement savings.” Or something to that effect. GAH.

  2. Jill, the problem with US healthcare — and Cat alluded to this — is that if you make too much monet to qualify for aid but not enough to pay for the cost of maintaining a chronic condition — asthma, arthritis, etc…– you’re sunk.

    What I find interesting is that so many people are afraid of government-run healthcare, but those who have it — people on Medicaid or Medicare, military, veterans, civil servants and government retirees — will fight to the death if you try to take it away from them. Which makes me think it can’t be all that bad.

  3. It’s always good to hear the different perspectives on topics like this. It’s also sad to see the “brokenness” of it all too. I know people who have gone to the ER for non-emergency stuff because they cannot be turned away, but this causes other problems for the ER and the hospital. Somebody has to pay for it. I’ve been to clinics that wouldn’t see me until I paid a “down payment” for just the office visit and then whatever happened inside, I’d have to pay when I left. Luckily it was something minor, but it was still high. I know so many people who won’t go to the doctor because they can’t afford it (doctor or the health insurance), can’t get the insurance because they have a preexisting condition. though that is supposed to be changing with the new healthcare program, but its still crazy expensive. And sometimes, the longer a person waits before going to the doctor, the worse the condition can become and the more expensive it will become to treat it. Anyways, I wasn’t going to get into all that, but I just thought I’d share some of my experiences. its a very complicated mess and that’s not even talking about the ethics.

  4. I think the most interesting turn in the ethics debate linked in the post was when the news host asked the crowd whether they believe religion has anything to do with right-to-life beliefs. The atheist and agnostic disability advocates about flew off the handle. It was great. :)

    And they’re right: it’s very, very true that being atheist or agnostic does not preclude a commitment to objective moral duties. In philosophical circles, regardless of the stance on theism, moral relativism is considered non-credible.

  5. Well, my hubby is a physician in the broken US system. We have a clinic in town that services preventive and maintenance care for those without insurance. My hubby’s group (radiologists) interpret all their films for free, by choice. When they cover the ER radiology, there might be almost half the films which would qualify as cya and not necessary. So they read films for people who can and those who cannot pay, and half the studies may not have been indicated by physical exam, but since Dr’s are expected to act perfectly, they order all kinds of extra tests to prevent lawsuits. Half of medicine is running away from tort lawyers. It’s despicable. Some doctors in florida have to earn $200,000/yr just to pay for their malpractice (that gets paid AFTER taxes). Then they can start to earn money for things like . . . food for their families. Who wants to give away 8-10 years of their life (med school and training) to start running away from lawyers who threaten to sue you for all the money you have and will ever make, and the government who threatens to lower their income before their medical school loans (can be upward of $250,000) are paid off? And then you have hospitals trying to cut costs which puts money before patient care. My husband has to fight for hospital policy to favor patient care. read: putting what’s best for the patient, before the bottom line. He doesn’t always win. I could go on for hours and hours. THis is merely the tip of the proverbial iceberg.
    Personally, I’d like to see a new system start underground and work its way up. I’m thinking about Dr. Baker from LIttle HOuse on the Prairie. Everything in medicine could be cash on the barrel. And it’s up to the doctor, he can accept a few chickens as payment instead of cash if he’s feeling generous.

  6. I am thinking of the doctor whose funeral I recently attended. He was one of those wonderful old-fashioned family doctors who always came to the house ($3) if you could not make it to his office ($1). And if you didn’t have that, he would take eggs or veggies or “put it on the bill” (which never was sent out).
    He was nearly 90 when he died & did not give up his license when he retired; he just kept making house calls until he entered assisted living. (Once, when I had no insurance, he wrote me a scrip on the back of the church bulletin after Sunday services, saying, “get this filled NOW; before you go home….unless you want me to go to the drugstore & get it myslef”. And he meant that).
    He is without doubt with his beloved Lord right now….probably scolding some saint of the past for not tending his/her health while still living. He was like that.

    The system is indeed broken here in the US. I think its pretty much broken everywhere, & the reason is that medicine is :-( no longer a calling; its a way to :-( make $$$$.
    At the funeral, one man stood up at the end, when we were sharing memories & told of the time that his mother had lost consciousness & nearly died, “& Doc stayed with her for 3 days, without going home”.
    That kind of thing is rare & wonderful & part of another time.

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