A medical system deeply dedicated to Hippocratic values of patient equality and uninfected by the “quality of life” virus would not need laws prohibiting discrimination against the sickest and most seriously disabled patients. Alas, doctors don’t take the Hippocratic Oath anymore and are under increasing pressure to consider costs when discussing treatment options. Moreover, Obamacare’s potent threat to establish future rationing of the kind seen in the UK threatens to institutionalize discrimination against the medically vulnerable.
In such an invidious milieu, anti-discrimination laws that govern the practice of medicine, alas, become necessary. One was enacted recently in Oklahoma that seems a good model for the nation. From, the Non Discrimination in Treatment Act:
A. A health care provider shall not deny to a patient a lifepreserving health care service the provider provides to other patients, and the provision of which is directed by the patient or a person legally authorized to make health care decisions for the patient:
1. On the basis of a view that treats extending the life of an elderly, disabled, or terminally ill individual as of lower value than extending the life of an individual who is younger, nondisabled, or not terminally ill; or
2. On the basis of disagreement with how the patient or person legally authorized to make health care decisions for the patient values the trade-off between extending the length of the patient’s life and the risk of disability
Hopefully, this will make it much harder for hospital bioethics committees and doctors to force patients off of wanted efficacious life-extending treatment.
This is a body blow to Futile Care Theory, as futilitarian Thaddeus Mason Pope acknowledges. That is a necessary corrective, with so many attempts now in advance directive and POLST proposals that would allow doctors to overrule surrogate decision making–even a patient’s own advance medical directive.