The Corner

Law & the Courts

Nevada Bill to Push Patients Off Wanted Life Support

(Luisa Gonzalez/Reuters)

Imagine your mother is in the hospital. She has written an advance medical directive instructing that her life be maintained even if things look very bleak. She has told you personally in an intense and intimate conversation, that she wants you to make sure everything is done to let her fight for her life.

A year later, your mother has a stroke and is fighting for life in an ICU. You try to do as she wanted, you instruct her doctors to maintain her life. But they say no.  She is very unlikely to recover, and even if she does, she will be seriously disabled. Her “time” has come, they say. And then, they unilaterally remove her life support over your strenuous objections.

That kind of authoritarianism already happens in Texas and a few other states. Now, Nevada has a bill pending in the legislature that would permit doctors to push patients off wanted life-extending treatment. From SP 189:

A medical facility is not subject to disciplinary action, shall not be  found  to  have  violated  any  standard  of  care  and  is  immune from  civil  and  criminal  liability  for  refusing  to  provide  care  or treatment  requested  by  a  patient  at  the  medical  facility, or by another person on behalf of such a patient, if a provider of health care:

1: Has  determined  that  the  treatment  of  care  would  not  be effective or is contrary to reasonable medical standards.

This is a bioethics meme known as “medical futility,” “futile care,” “inappropriate care,” or “non-beneficial care” — the bioethicists are still working on the best lexicon to get their policy goals enacted.

The point of futile care is not to protect doctors from forced provision of treatment that isn’t working — sometimes called physiological futility. Rather, it is to enable doctors to stop treatment even though it is accomplishing what the patient wants, i.e., maintaining life. Here are some important points to ponder when considering this issue:

  • Futile care says maintaining life when the patients wants to stay alive is not an appropriate intervention in some cases.
  • Proclaiming treatment futile or inappropriate is a value judgment–not a medical determination — about whether the life in question is worth living, and/or worth paying to sustain. It essentially declares the patient futile.
  • Futile care decisions may be distorted by prejudice against disabled patients, the elderly, and other minorities.
  • Futile care involves collective decision-making that empowers strangers to make crucial decisions about a person’s life and death. It gives greater weight to institutional and professional values than to those of the patient and his or her family.
  • Futile care is a form of ad hoc health care rationing. That means an intervention considered futile in one hospital might not be in another.

If Nevada legalizes assisted suicide, which is being attempted this term, and also passes this futile care bill, the lives of the most medically vulnerable will be put at material risk both coming and going. If a dying patient wants to commit suicide, great. Bioethicists believe in patient autonomy, so the law will authorize doctors to give them the poison pills.

But if a patient wants to continue to stay alive on life support, suddenly patient autonomy will have its limits and the subjective values of doctors and bioethicists could trump those of patients and families.

That’s known as heads we win, tails you lose. Let’s hope that the Nevada Legislature rejects this awful bill.

Something to Consider

If you enjoyed this article, we have a proposition for you: Join NRPLUS. Members get all of our content (including the magazine), no paywalls or content meters, an advertising-minimal experience, and unique access to our writers and editors (conference calls, social-media groups, etc.). And importantly, NRPLUS members help keep NR going. Consider it?

If you enjoyed this article, and were stimulated by its contents, we have a proposition for you: Join NRPLUS.


Most Popular


‘Epstein Didn’t Kill Himself’

It was just one more segment to fill out the hour, and thereby fill the long 24 hours of Saturday’s cable news on November 2. Or so it seemed. Navy SEAL Mike Ritland was on the Fox News program Watters World to talk to Jesse Watters about trained German shepherds like the one used in the raid that found ... Read More

A Defining Statement of Modern Conservatism

The greatest documents in American history never lose their ability to astonish. They deserve, and repay, careful study, and inevitably have contemporary resonances no matter how long ago they were written or uttered. There’s no doubt that Ronald Reagan’s “A Time for Choosing” belongs in the top ranks ... Read More
White House

The Russian Conspiracy That Won’t Die

The Mueller report accomplished nothing. Whether you thought that the two-year, $32 million investigation was warranted or not, the report promised to establish a factual record that both sides could accept, especially on the explosive charge that Donald Trump had conspired with the Russians to win the ... Read More
White House

Impeachment Theater of Trolls

As a boy, I used to watch a television show with a weekly gag titled “MasterJoke Theatre.” A pompous egghead smoked a pipe in a leather-bound chair in a richly appointed library, told a joke, and got a pie in the face for his trouble. What the Democrats launched on the Hill this week is their own variant, ... Read More