While the United States is busy wrestling with the so-called right to die, in the United Kingdom it's the right to life that is in question. Leslie Burke, who has a degenerative brain disease, has won a court judgement forbidding doctors to withdraw nutrition and hydration should the time come when he needs them and is incapable of expressing his wishes. The government is challenging the decision, claiming that doctors, not patients, should be the final arbiters of treatment decisions. Nor do they make any attempt to disguise their financial concerns, for under socialized medicine, leaving the power to "pull the plug" in the hands of those who wish to continue to live can get very expensive for the government.

Consider these statements:

  • The health department claimed that if a right to artificial nutrition or hydration (ANH) treatment was established, patients would be able to demand other life-prolonging treatments
  • [The government argued that the ruling] may be interpreted as giving patients the right to demand certain treatments, contrary to the considered judgment of their medical team, that would lead to patients obtaining access to treatment that is not appropriate for them, and to inefficient (and unfairly skewed) use of resources within the NHS
  • [and also that the ruling] had led to a confusion between the roles of doctor and patient—the decision over treatment [is] for the doctor, not the patient

In the words of Mr. Burke's lawyer, "The key issue could be summarised in two words: who decides?" It's not an easy issue, and it won't go away. I remember a conversation with an anesthesiologist friend 25 years ago, in which he warned that health care resources are not infinite and like it or not we will have to make decisions as to how they are allocated. A capitalist system, in which money provides access to health care, seems at first to be monstrously unfair, but I'll take its flexibility any day over socialized medicine, in which life and death decisions—still made on an economic basis; that's unavoidable—are in the hands of an inhuman, faceless bureaucracy. When decisions are left up to individuals and smaller institutions, creativity and compassion have room to flourish. People can cut back in other areas of their budgets to provide for medical care; families and communities can unite to raise funds; deals can be worked out. A friend of ours who never had medical insurance needed a quadruple heart bypass operation. The hospital asked him to pay his $150,000 bill of at a rate of $100/month. He won't live long enough to pay it off, but this solution pleased both him and the hospital. The more decisions are left at a local level, the more flexibility we have.

One thing I know: I agree with Mr. Burke that I don't want a doctor, a lawyer, a judge, or anyone else who doesn't know me extremely well deciding that my "quality of life" isn't worth living.
Posted by sursumcorda on Thursday, May 19, 2005 at 8:08 am | Edit
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Wired Magazine has an article titled Computers No Cure for Dumb Docs

Posted by Peter Venable on Thursday, May 26, 2005 at 12:05 pm
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