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Human Exceptionalism

Life and dignity with Wesley J. Smith.

Why MD “Quality of Life Ethic” is Dangerous



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I can’t tell you how many times I have been called by desperate people fighting hospitals and doctors not to give up on their desperately ill or injured loved ones.

Sometimes the cases seem beyond effective remedy. But sometimes, it does seem as doctors or bioethicists want to give up because they don’t think the life they can save will be worth living.

An anecdote from the noted pediatric neurosurgeon, Dr. Ben Carson, illustrates the point. From, “A Physician’s View on the Sanctity of Life:”

A couple of decades ago, I came into the pediatric Intensive Care Unit on morning rounds and was told about a four-year-old girl who had been hit by an ice cream truck, and was comatose and exhibiting little neurological function other than reactive pupils. I tested her pupillary reflexes and both pupils were fixed and dilated.

The staff indicated to me that this is something that must have just occurred. I grabbed the bed and with some help, transported her quickly to the operating room for an emergency craniotomy. I was met along the way by a senior neurosurgeon who told me I was wasting my time and that at best, we would end up with someone in a vegetative state.

Nevertheless, we completed the operation and a few days later, her pupils became reactive and she eventually left the hospital. I saw her a few years ago walking through the hospital with her own 4-year-old little girl. She was neurologically fully intact and told me she had become somewhat of a celebrity because of the experience I just related. 

I have had similar, although certainly much less direct, experience after giving a speech in Canada about ten years ago. A distraught mother came up and tearfully told me how doctors were trying to pull the plug on her desperately ill daughter because they were convinced that if she survived, she would be seriously disabled.

The mother didn’t care. She wanted her daughter to live! But she was receiving such little support from others she was near despair. I encouraged her and and gave suggestions on how to fight against the medical authoritarianism.

A few years later I was in Canada speaking again and a woman came up. “Do you remember me?” she asked. I vaguely recalled the face. She reminded me of our conversation, then motioned to a beautiful teenager, who walked up smiling: “I drove two hours to see you because I wanted my daughter to meet the man who saved her life.” 

When I could speak, I protested. I hadn’t done anything: She had won the fight that shouldn’t have been necessary. But I’ll tell you, I had to go into the parking lot for a few minutes before I was ready to talk.

The moral of the story isn’t that these two cases turned out well. For the morality of the thing, that is irrelevant. The point is that life should be considered the core question, not its predicted quality. That is certainly an issue in discussions around informed consent. But it should not be determinative in whether the life-saving treatment shall be rendered.

It would be devastating to medical professionalism and what remains of our sanctity of life culture if “saving life” when that is wanted is replaced by an ethic of, “we will save your life if we think it is worth saving.



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