An intrepid reader sent me this on-line syllabus from a bioethics course at the University of Washington Medical School. I checked on the link protocol and the author Nancy Jecker, Ph.D presumes that the right to refuse wanted life-sustaining treatment already exists. From the syllabus:
While you will hear colleagues referring to particular cases or interventions as “futile”, the technical meaning and moral weight of this term is not always appreciated. As you will make clinical decisions using futility as a criterion, it is important to be clear about the meaning of the concept.
Futilitarians often deny that Futile Care Theory is about money. They deny it is about ideology that presumes some lives not to be worth living. As the following quote shows, it is about both:
The goal of medicine is to help the sick. You have no obligation to offer treatments that do not benefit your patients. Futile interventions are ill advised because they often increase a patient’s pain and discomfort in the final days and weeks of life, and because they can expend finite medical resources.
Although the ethical requirement to respect patient autonomy entitles a patient to choose from among medically acceptable treatment options (or to reject all options), it does not entitle patients to receive whatever treatments they ask for. Instead, the obligations of physicians are limited to offering treatments that are consistent with professional standards of care.
Realize that futilitarians are changing the fundamental purpose of medicine to suit their beliefs. One such fundamental purpose is to extend life if that is what the patient wants. Futile Care Theory arrogantly presumes the right to tell a patient and his or her family that their life isn’t worth extending–which is to say, that it isn’t the treatment being judged “futile,” but the patient. And, it apparently presumes the right to censor information a patient or family need to make proper informed consent.
The futilitarians are acting as if they have already won this bioethical controversy. But their agenda is running into strong head winds. As failed attempts to impose medical futility in Texas–where there is a law explicitly permitting it–demonstrate, we the people are not going to just roll over and let ethics committees meeting behind closed doors decide when the time has come for their baby, grandma, or a spouse to die. The more public we make this fight, the better chance we have to stop this ad hoc health care rationing/medical discrimination in its tracks. After all, in this fight “choice” is on our side.