The difference between withholding brutal treatment and killing someone

In the old days, medical treatment was more likely to kill than to cure.  For example, one can make a good argument that George Washington died because his physicians bled him to death.

It’s scarcely strange, then, that homeopathy was such a hit when it first appeared on the scene.  The principle, as I understand it, is that one puts a drop of something medicinal (or, often, poisonous) into a container filled with pure water.  Then, one takes one drop of that mixture and adds it to another container filled with pure water.  And then, one repeats that process again (and, perhaps, again).  The end result is a container filled with pure water.

People who practice homeopathy believe that the water has the essence of the medicine, and therefore has a curative effect.  Whether that is true or not, a patient in 1820 who was given pure water to drink was likely to suffer less, and perhaps heal better, than the patient who was bled, cupped, given mercury, and subject to other horrific pre-modern medical treatments.

Nowadays, medicine is much more effective, although some of the side effects can be every bit as nasty and even fatal as the old medicines.  Speaking personally, while I know Vicodin is an effective painkiller, I’d rather take the pain that the extreme vomiting reaction it induces in me.  Still, if Vicodin doesn’t work, there’s usually something else out there that will, if not as well, at least enough to be worthwhile.

The whole equation changes when people are at the end of the road with terminal illnesses.  At that point, curative medicines and treatments have ceased to cure, leaving the patient with the side effects, but no benefits.  Socialized medicine holds that, at this point, the State gets to call the shots, determining that the person with the illness should no longer get the treatment.  The only problem is that people don’t slot themselves into neat little charts.  Some are dying, but want to live; some are living, but want to die; some are told they will die, but their bodies refuse to listen to the message and insist on getting better.  Allowing individual decisions in an open marketplace is the scenario most likely to allow people to fulfill their biological destiny, whether it’s a swift death, or a slow one, a longed-for death, or one that the person fights against bitterly.  Leaving the process to the government ensures only that more will die regardless.

I actually blogged on this topic almost two years ago during the ObamaCare debate.  I focused on people I knew who had insisted, when healthier, that they wanted to die but who had discovered, when death came calling, that they wanted to live.  In a pre-ObamaCare world, both of these people were allowed to try for life.  Both ultimately died, but they were around longer than they would have been if the government had announced that they were unsalvageable.

Today, Zombie touches on the other side of that equation:  someone who, like my dad and my friend, thought he wanted death but who, unlike them, was denied the opportunity to change his mind.  What makes Zombie’s story especially horrific is that this was not a situation in which his relative simply had treatment withheld.  As I noted at the start of the post, when treatment becomes useless and onerous, withholding it may be a wise and humane decision.  Instead, it’s a story of a battle between caregivers, with some wanting to care for the body, and others intent upon hastening death.

After you’ve read Zombie’s post, please come back to me and share your thoughts.  If I had to summarize my view it would be this:  If I come to a point in my life when treatment is only painful, and offers no hope, I don’t think I’ll want treatment any more.  Nevertheless, that doesn’t mean I want my doctor or my government to hasten my death.  Instead, I want to be made comfortable.  I want to be fed, hydrated and medicated so that my body (and my soul, if I have one), can make the journey as nature (or God, if he exists) intended.

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Comments

  1. says

    I read Zombies post and thought it touched on alot of the concerns that those who haven’t been in that situation are unaware of.  I am so glad that I had my in-law’s support when I went ahead with having my husband removed from life-support but I did feel that there was a certain pressure from the (Catholic) hospital to get on with it as soon as they got the final diagnosis.  I was even enough afraid when I went across the street to get some dinner that he would be gone when I got back once they had my agreement that I didn’t want him to suffer that my Father-in-law went back to make sure they understood I didn’t want my husband to have that much help.  Although, in fairness, it could have just been that I was really stressed and seeing an attitude that wasn’t actually there.  He was gone in just minutes once we removed the ventilator but I did make it clear that if he lingered I didn’t want him dying of dehydration or hunger although it sounded like the rules tend to be very all-or-nothing and I’m not sure how that would have ended up working.

  2. Charles Martel says

    Ymarsakar, obviously you didn’t read the claims at the time by the media’s amen chorus regarding Terry’s almost blissful descent into final rest. Horrible death? What horrible death? I saw article after article that went something like this:

    —Dehydration and starvation induce a sort of dreamy giddiness in the dying person. She didn’t suffer at all.

    —Or, since Terry was no longer a person—in any sense that would satisfy a leftist—it didn’t really matter anyway whether she was suffering because there was no real person there to suffer.

    —Her suffering, if any, served a higher duty, namely the right of her estranged husband to have her dispatched as a private matter. Terry’s death helped us uphold the sacred matter of the government keeping its nose out of private business (unless it involves our eating the wrong foods).

  3. Libby says

    That’s quite a post by Zombie. Luckily my parents have very detailed documentation specifying their wishes in the event of various medical conditions. Guess my husband and I need to get this in writing, too. The wild card, though, is the cooperation from the medical staff (now, more scary with ObamaCare). Nameless, faceless bureaucrats can deny or delay treatment leaving one with little or no choice but pallative care.
    And regarding Zombie’s concern that the Larry made these decisions while depressed, it should be recalled that over 70 percent of Kevorkian’s “patients” were not even terminally ill. Some were depressed, and five weren’t sick at all, according to the autopsies: http://www.nationalreview.com/articles/206953/dying-cause/wesley-j-smith
    And Ymarsakar, I remember quite vividly how callously people dismissed Terry Sciavo’s humanity and her right to live, and they were actually impatient with her parents’ attempts to keep her alive. The mask really slipped on those ghouls who so eagerly chanted for them to just end it already.

  4. Tonestaple says

    I have been handed living wills by doctors on more than one occasion, even though there was nothing wrong with me.  I have never felt trusting enough to actually do anything about them and, after reading Zombie’s tale, I don’t know that I ever will.  I’ve been leery of advance directives ever since I read about what the Netherlands does to its old people, killing them as convenient because they need the beds.

    Was it here that was posted a link to an old article by Ramesh Ponnuru which said that abortion corrupts everything it touches.  I saved that article and it includes this:  “Pro-lifers were, alas, more prescient.  They claimed the West had started down the slippery slope of a progressive devaluation of human life.  After the unborn would come the elderly and the infirm – more burdens to others; more obstacles to others’ goals; probably better off dead, like ‘unwanted children.’ And so now we are debating whether to allow euthanasia….”

    More than anything else, it is the medical profession that has been corrupted by our massive failure to respect human life.  Instead of being an “angel of mercy” a nurse has turned herself into a near-executioner.  Instead of being healers, doctors have turned themselves into near-killers.  We are supposed to trust these people with our lives, but I don’t see how that’s possible any more.

  5. suek says

    >>Luckily my parents have very detailed documentation specifying their wishes in the event of various medical conditions.>>
     
    I’m not certain that there is _any_ documentation that can’t be twisted to mean something else – especially if the person most affected is unable to speak for themselves.  What is needed is someone you (the affected person) can _trust_ absolutely.
     
    What was that song about learning how to treat dad by watching dad care for _his_ “dear old dad” (and not a very pretty lesson at that)?

  6. Michael Adams says

    I have learned, both in my professional life as a nurse and as someone who has had to make decisions regarding elderly relatives, to avoid the DNR order, because it is usually taken as “Do Not Treat. As soon as you say, “No CPR,” they want to discontinue antibiotics. It ought not to be that way,  but it is. We went through it with my father-in-law, seven years ago, and with my own father, in the last two weeks.
     
    I did not know until recently that Florida law considers feeding tubes to be “Life Support.”  The generally understood meaning of that phrase is “ventilator”. For fifteen years I have had only one patient who could breathe.  The rest are on vents, with cognition ranging from acute, in a retired college professor with whom I had delightful hours of debates about topics in linguistics, to a young girl who has almost reached her majority, without ever speaking. The girl’s mother is gripped by guilt, a subject for another day.  The retired professor had one of those “families of choice,” so common in academics, who often marry late and have no children. He was quite alert and aware, but every time he got an infection, urinary tract, a tooth, even a bad cold, he went a bit goofy.  His chosen deciders were ready to let him go, every time. Finally, when I was off the case for a couple of weeks, he got sick again, and they finished him off.  This was NOT his wish.  He told me many times that he wanted to live, to hang around at least as long as his mother, who passed a hundred. Every one of his circle was a Democrat, but for him, and their functional approach to human life was utterly chilling.
    I am struck by the deep impact Terri Schindler’s (I refuse to call her by the name of her “husband.”)case has had on the thinking of people whose opinions  I so profoundly respect, including Y-guy, Danny, Sue, Charles Martel.  I trust my wife and son, but, if I did not, I would have y’all appointed to a committee charged with making the correct ethical judgments  in my case.
     
    My experience with my father, and with Patient L. and his “family” only served to intensify and personalize my aversion to letting such people make our health care decisions, as in Obamacare. I say this not as one who is overcome by emotion, although the emotion of revulsion certainly does arise, but as somebody who has eaten and slept these matters for decades.  I am very well aware that cold heartlessness does not always produce cool clear logic.

  7. Charles Martel says

    Michael Adams, the very first thing I think about when I think about Terri Schindler is that my wife supported her murder, citing the litany of rationales that the media were spoon-feeding people at the time. It was one of the most chilling moments of my life because I realized that if she could be persuaded dismiss Schindler’s right to life she could probably be persuaded some day to dismiss mine.

    I subsequently changed my power of attorney and my orders specifically forbid her to make any medical decisions on my behalf.

  8. says

    I am very well aware that cold heartlessness does not always produce cool clear logic.

    This is such an important point since all too often cold heartlessness seems to be conflated with cool clear logic.

  9. suek says

    The Terry Schindler case (and I agree with your feelings about her “husband” {if there is “common law marriage”, why isn’t there “common law divorce?} )  raised so many questions – among them why was the Florida law changed in 92 so that the feeding tube protocol was changed from “ordinary” care to “extraordinary” care?    I’ve wondered who and why that issue was even raised.  Perhaps there was good reason for it – but I’d really like to learn more about it.
     
    Apparently, the Scientology religion is particularly strong in that county of Florida, and the Judge that made the decisions in that case is also one.  Also, I understand that Scientology writes off “defective” individuals – which certainly fit Terry to a T in that situation.  I wonder if that had any influence on his decisions.  Again – questions raised, but never answered.
     
     

  10. says

    Indeed, it is a very moving piece by Zombie. 

    However, it still does not change my mind on what I believe – medical, health, and certainly end-of-life decisions belong to the patient and his loved ones, with input from the doctor.  No one else should have a say in the final decision.  So-called “living wills” should be used by loved ones to help them make the decision when the patient cannot.

    All the right-to-die folks, the right-to-live folks, and all other busy bodies need to butt out of a PRIVATE decision.  I was so sickened by those outside Terry S.’s hospital saying that they were praying for their “friend.”  Friend?  I doubt they even knew her, such a false intimacy is truly sick.

    That being said, I also believe that there are many, such as “Dr. Death”, who are not acting in the best interest of the patient.  They so clearly have a political motive behind their actions.  I think that is the real reason they prosecuted Dr. Death.

    Also, patients who are in great pain, so badly that they want to end their lives, are not in a “sane” mind. And, therefore, cannot make rational decisions. Pain has a way of screwing with one’s reasoning.  Would a shrink in dealing with a patient with suicial tendencies, treat that patient’s illness or help him to end his life? Rhetorical question as we know what that doctor is required to do. So, with those in great pain, better pain management is needed when a patient talks about ending his life.  Helping the patient commit suicide is a lazy way out.

    I, also, fear with Obamacare we will have more government intrusion in our healthcare lives, not just death panels as Palin has suggested.  Wait a generation or two until it becomes “normal” for the government to decide who lives and who dies, most folks will just go along with it.  Now, that is scary!

  11. says

    Schiavo had a conflict of interest. SOmehow, he was put into legal authority over Terry even though Schiavo had a new wife and family. This is called a conflict of interests. Schiavo is no longer the “loved one” of Terry. And the women’s rights groups should have been up in arms, but they weren’t. Because they wanted her to die. She had to die, in order for them to gain more power, wealth, and influence. If women or men could make their own medical choices or if the state could not control who is or is not in control, then there will be revolts against Leftist rule. Including against NOW and the public sector unions. So they said to themselves, “what’s one more death when it will help the all mighty Cause”. Millions of unborn have already died at their hands. What’s one more death to them.
     
    This also goes into the issue of individual choice. If people can pay for it, they should be able to get it. That is the general one. But the government says that you can only get something if taxpayers are forced to pay for it. They don’t want you to pay for yourself because it removes you from their influence. They want you under the dole. If Terry’s family could pay for her medical costs, they must be prevented from doing so. If families can use vouchers and their own money to pay for private school, they must be stopped. Otherwise the unions lose power. The government loses power. They don’t have “leverage” over people unless those people are forced to take money and benefits from the government. Thus the individual freedom of pay for what you want, must be eradicated.
     
    And they do so either by making the service too expensive through regulation, unavailable through laws such as ObamaCare, or simply making it illegal. They can also crash the economy and make you jobless, so you don’t have any money to pay for what you deem important.
     
     
    Friend?  I doubt they even knew her, such a false intimacy is truly sick.

    You are speaking for yourself. But you cannot speak for them. For you don’t know them, now do you. If you claim they are false because they knew Terry not, then what are you basing your views on, telepathy?

    Michael Adams, my primary goal would be to make them happy. If people are going to die, they might as well die still enjoying life. The Left thinks being happy is about being free of pain or being high on drugs. I think happiness has to do with doing what people need to do to feel that they have accomplished something worthwhile in life.

    If they can see, they can read books. If they can write, they can write re-collections of their best times. If they have unsettled family business, they should have regular meetings with their family to tell stories. All of these things they can do. If they don’t want to do any of that, then they are already dead. And that’s that. If people do not want to do anything, then they are dead already. If people desire something to do, then they wish to live still, for a time.

    The primary consideration is cost, of course. Living isn’t free, when you can’t support yourself. But if the cost isn’t an issue, if the treatment is within one’s economic means, then the choice now becomes available. People must decide whether the money should be used to prolong their own life or whether it should be used to better the lives of the next generation. What is important to a person at the end of their life, differs.

    If they have not thought about this nor do they have anyone they can trust in guardian to this decision, then family and doctors can neither be objective nor empathetic enough. Family members often want an inheritance or want to stop paying costs. The closer they are, the more conflicted their interests are, even. This is no “objectivity”. Nor is objectivity the goal even, for someone making decisions concerning emotional relationships.

    In this scenario, life is the only choice. If a comatose individual cannot pay to maintain their life, then the choice is out of their hands. But if the funds are adequate, then they should be kept alive until they wake and become able to make their own choices. Charities or donations from family/strangers are also available to keep a person alive.

    That is the only ethical standpoint vis a vis comatose individuals. Wait for them to wake up, if they have no legitimate guardian. Now if they have no money, and it requires huge expenses from the taxpayers or unwilling family members, then their life is sucking the life out of others, which is wrong. In that scenario, absent charity, their life can no longer be justifiably maintained at the expense of others.

    In Terry’s case, her family was going to pay her medical upkeep costs. There was no contradiction. The best choice was life, for only in life can people CHOOSE to do anything. And if the Left was so concerned about freedom of choice, they would be for life. But the Left hates liberty, so they are for death. It is all very logical in the end. Death is the final destruction of liberty. And it is the death of liberty that they seek, above all else.

     

  12. Charles Martel says

    It’s interesting that the left, which wants only to push the boundaries of freedom ever outward, has such a crimped view of human beings:

    All humans are entitled to life unless:

    —They haven’t been born yet. (However, if mothers declare that they are carrying babies, simply uttering the magic word “baby” turns the fetuses into humans.)

    —They are capable of leading a life that has “quality” in it (said quality to be determined by a panel of doctors and “bio-ethicists”).

    —They do not cost an inordinate amount to keep alive, said costs based on a manifesto somewhere that says all human lives are equal when it comes to what you may expend on them. (Exceptions are lawmakers, academics and Paul Krugman.)

    When medicine becomes socialized, death becomes socialized, too. Thus the many can decide for the one when and if he should die. (I believe the Commerce Clause covers this because many corpses get carried across state lines. Although one can decide to put off death, that decision has an economic effect by denying funeral homes their rightful income and, therefore, falls under government purview. So, the government has a constitutional right to determine that it is in everybody’s best interest that you die.)

  13. says

    Government is naturally the use or threat of force to keep humans in line. HUmans, requiring a hierarchy in which to function and live, need an enforcement agency to ensure social cohesion, security, and obedience to the common rules.
     
    The Left, by making more and more use of government authority in meaningless or non-essential fields, is turning totalitarian bit by bit.
     
    There is no such thing as a partial government decision. Either you are guilty or you are not guilty. Either they put you in prison for a crime you didn’t commit, or you did commit the crime you were put in prison for. Either the FBI killed a bunch of children at Waco with a fire or they didn’t. Either the FBI chief in charge of Waco and Ruby Ridge gave the order to kill civilians, or he didn’t.
     
    When using government power, there’s not a lot of “oops, my bad, let me take the defective merchandise and give you a refund” about it. When government power is defective, you’re mostly dead or lose something important permanently. It can’t be returned. Sorta like Madoff and Enrion. The money’s gone people. You can at most get some of it back (in like a few decades), but most of it is gone.
     
    Yet people want more Enrons and Madoffs, backed by government authority no less. It’s not such a sure bet by my lights. Federal government has an enormous deficiency when they try to govern people hundreds of miles away. This is why the US was constructed of states first and federal government second. If people want state funded healthcare, they can vote for it by state. If the People’s Republic of Mass. believes they are rich enough to pay for it, and want to, go ahead. We’ll just have people that need healthcare move to Mass, then leave. If they can sustain that system economically, more power to them. But when it comes to federal government, that’s a one size fits all prospective. One cannot move out of the country as easily as moving out of a US state to another state. People are kept trapped by their circumstances, with no freedom of movement, and thus no freedom of association/choice either.
     
    If the Left wasn’t evil, they would be satisfied with a workable system that is based upon what each state decides is best for their people. Rather than somebody ruling on high from hundreds of miles away deciding what is or isn’t “best”. There is far more accountability for a state’s governor and representatives, than there is for a Senator from Iowa when somebody from Alabama gets pissed at being tax raped by the federal government and seeing the funds shipped to Iowa, not Alabama. This tends to get people into “factionalism” (read civil war), where they try to get more and more federal power in order to “control” things. An arms race for federal power, sucking up money that could have gone into self-improvement at the local level, as well as small business stimulus.
     
    There’s a reason why the Left keeps pushing for more federal government power, regardless of the negative consequences it has on government efficiency or accountability. And it’s not because they don’t know what the hell they are doing. They know exactly what they are doing. And they’re doing it.
     

  14. says

    Martel, of course in your long ancient life, you should have remembered that the Left only believes life is a right for murderers, terrorists, pirates, and good party members.
     
    Islamic jihadists? Life.
     
    People they don’t like? Death
     
    People they don’t like who can’t defend themselves? Death by starvation and dehydration.
     
    Have them take a trip to GitMo and get some starvation and dehydration. See how pleasant it is. Of course they’d lobby for terrorists if terrorists weren’t fed 5 halal meals a day.

  15. Charles Martel says

    Ymarsakar, you don’t understand: Gitmo is a form of torture, prohibited by the Geneva Conventions. The laws on war are clear: You must feed prisoners enough to sustain life, but 4,000 calories a day flouts the law and is plainly intended to cause obesity (thus, diabetes, heart problems, gout).

    Allah forbids obesity unless it has been funded by monies taken from dhimmies. By violating the requirement that the prisoners do the taking (usually at gun or knifepoint) Gitmo further demonstrates an inhumane regard for their culture.

  16. says

     
    Forgive my “shouting”, but this is important:
     
    DO NOT SIGN A “LIVING WILL”
     
    DO NOT SIGN AN “ADVANCED DIRECTIVE”
     
    These documents operate to take decision-making out of the hands of a patient’s family or other loved ones, and vest it in strangers who answer more to financial or ideological influences than to the well-being of the patient.
     
    There is an answer — The Will To Live.  You can find out about it and download a copy here:
    http://www.nrlc.org/MedEthics/WilltoLiveProject.html
     
    Please, folks — get yours and fill it out….then tell everyone you know.

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