Care to Die
Intravenous food-tubes and respirators are being pulled from patients who do not display signs of consciousness. But should the law and the medical profession guarantee opportunities only for the strongest patients?
August 17, 2009
In the waning moments of the Bush administration, the White House issued what came to be called the “conscience rule.”
The rule was aimed to protect the rights of physicians and other health care practitioners. The conscience rule directed that no physician or other health care practitioner should be compelled to perform medical procedures which he or she deemed to be in violation of that practitioner’s private moral beliefs. That is, in a state where abortions are freely performed under law, or patients are taken off of life-support, a physician could essentially say, without facing disciplinary procedures or legal action, “Find someone else to do that. I think it’s wrong.”
What would seem like a natural extension of the physician’s traditional Hippocratic Oath, founded on the principle of “Do no harm,” actually made some waves at the time it was issued. It was speculated that the Obama administration might act to overturn the “conscience rule” after taking office as a gesture of political triumph.
After all, abortions and euthanasia have long been rallying points for the traditional Democratic base. What better way to eliminate the “moral” stigma as a hurdle against expanded abortion rights and greater application of euthanasia, than to eliminate the so-called “conscience rule.” Yet the Obama administration was cool to take up the challenge.
Underlying the ideological and political arguments is a disturbing fault line in the very definition of what it means to be a human being. The opponents of the “conscience rule,” and those who defend ethically questionable moral procedures, not only strain to impose their own sense of compassion on the rest of society. People who advocate that the art of medicine be denied to care for the weak and the helpless, such as comatose patients and unborn children, are actually championing a brutish philosophy that denies help and protection to those who need it most.
We’re going to tell you a story now. The story begins with the grief of a suffering parent, and ends with catastrophic bloodshed.
Early in his tenure as Chancellor of Germany, Adolf Hitler, his name should rot, was contacted by a father asking for help for his son. The man begged the Chancellor to help defray the cost of medical care for his severely disabled son, and appealed to the mercy of the Fuhrer, his name should rot, to help a son of the German people. Hitler responded to the man’s correspondence. He said that the man’s disabled son was a disgrace to the German race, and he was ordering that the boy be put out of his misery by executing him.
The 1998 documentary “Healing by Killing,” directed by Nitzan Aviram, records this espisode, and chronicles the rise of the importance of the medical professionals in Nazi Germany in advancing what would amount to mass murder on a scale never before witnessed by the human race. The doctors were first issued a request, from the government, how to most efficiently perform euthanasia on the infirm, the disabled and the mentally handicapped people who were sent to their hospitals and clinics. The Fuhrer, his name should rot, wanted the German people to only be healthy and strong. Soon, the doctors found a greater challenge, in how to administer this euthanasia on a larger scale. They noticed that their offices were swelling with referrals of dissidents, critics of the government, and other people accused of having “political” illnesses which required their being euthanized as well.
The concentration camps which we know of today were the result of painstaking efforts by German doctors to design the most efficient means of killing the largest number of people at once. Zyklon-B gas, a pesticide, was found to put people to death the most quickly with the least amount of messy side-effects.
The point of this story is not to advocate on behalf or stand against any current piece of legislation, nor is it to demonize any particular person, organization or political group (except the despicable Nazis and any of their supporters). The point of this story is to show that people who get involved in redrawing moral lines according to the dictates of their supposed “enlightened” intellectual reasoning, begin to blur lines and set forces in motion that can become indomitably powerful once the momentum of politics and business are brought to bear. When people break away with traditional institutions of morality, particularly, those guidelines taught us by our religious traditions, everything is up for grabs, and the society inclines itself towards a rapid spiral into disaster.
Right around the time of the “conscience rule” directive being issued by the White House, a dark mirror image of this policy was published in the medical journals. The January issue of American Psychologist, the journal of the American Psychological Association, released a chilling affirmation of a grotesque portrait of human beings as mindless beasts. Dr. Jerry M. Burger recreated an experiment pioneered in the 1960’s and 1970’s by Dr. Stanley Milgram, which was designed to show how people are compelled to inflict pain on strangers when impelled to do so by an authority figure. Time magazine summarizes the experiment:
“Volunteer participants were enlisted to help with a study purportedly tracking the effects of punishment on learning. When the “learner” made an error, the volunteer was told to administer an electric shock. Milgram found volunteers were disturbingly willing to follow orders, even as voltage levels increased in intensity and the subject’s mild protests escalated into anguished shrieks. (The shocks were fake; both the learner and the authority figure prodding the volunteer were complicit in the experiment.)” “Why We’re OK with Hurting Strangers,” by Alex Altman, Time, Dec. 19, 2008.
“The main question is how far the participant will comply with the experimenter’s instructions before refusing to carry out the actions required of them,” Dr. Milgram wrote about his original study, in his 1974 publication Obedience to Authority. Under Dr. Milgram’s study, later repeated by Dr. Burger last year, the picture that emerged of ordinary people was one of mindless, immoral jellyfish.
Also around that same time last year, the Brody family, Orthodox Jews staying in Maryland from Brooklyn, suffered a devastating tragedy. Their young son Motl had been diagnosed with brain cancer, and was receiving care from the Children’s National Medical Center. At a certain point Motl fell unconscious, but was kept alive with the help of life-support equipment at the Hospital. The Hospital informed the parents that the Hospital planned to disconnect Motl from life support because, under the law of the state of Maryland, Motl had entered what they call “brain-death.”
“Brain-death” is refers to a scenario where certain instruments cannot detect brain wave activity when directed to monitor a patient’s brain. Even though other life activities continue, advocates of brain death point to the stillness of the machines to support their claim that a patient is “pretty much dead” and therefore worthy of being denied life-sustaining treatment.
While his heart continued beating, and other body functions continued, the Hospital argued that Motl was already dead. “Although Motl had been pronounced dead,” the Associated Press wrote on November 16, 2008, “his heart was still beating with the help of a cocktail of intravenous drugs and adrenaline.”
Let’s pause for a moment to appreciate the Hospital’s claim. They are insisting that the presence of a heartbeat in a patient is basically meaningless. The thing that grants life to patients, according to the Hospital is, “a cocktail of intravenous drugs and adrenaline.”
When has a doctor or scientist ever been able to make “a cocktail of intravenous drugs and adrenaline” into a heartbeat where there wasn’t one moments before? Since when did it become acceptable to discard a failing human life as if it were a defective pack of firecrackers?
The Brodys took the Hospital to court to block them from removing their son from life support. They argued that as long as the boy’s heart continued beating, he was still alive. The Hospital responded that because their instruments could not register any brain wave activity, then regardless of the hearbeat, the life-support equipment was simply inflating and deflating the lungs of a dead body.
In documents filed at D.C. Superior Court, also reported by the Associated Press, the Hospital argued that its “scarce resources are being used for the preservation of a deceased body.” The case was withdrawn, however, when Motl Brody was reported to have suddenly died. The Associated Press said the death of Motl Brody made the need for the court ruling “moot.”
The concept of “brain-death” is a vicious lie which has misled countless, well-meaning but weary relatives of seriously ill patients to become unwitting accomplices to murder. The adherents of brain-death place blind faith in medical technology. People who believe in Gd hope that He will help them overcome difficult odds. Blind faith in medical technology gives brain-death advocates the strength to ignore the most basic signs of life. They insist literally that white is black, that a person whose heart beats, hair and nails grow, and body processes continue to function with the assistance of their devices is in fact not alive.
The hubris of brain death advocates can only be understood that the fervor of their faith is grounded in some very practical concerns. The need for brain-death stems from a need for a way of classifying as “already dead” people for whom the provision of medical care is burdensome. The true people being put “out of their misery,” as pointed out by John Hanks, Professor at the Benjamin N. Cardozo School of Law, are the relatives who wished they were simply relieved of the duty of caring for their weak and infirm loved ones.
Oftentimes these people selected to make the “choice” of whether to continue to preserve the life of the patient are the absolutely worst people to ask, Professor Hanks said. These “guardians” are often relatives who may often tire quickly of the demands of prolonged care, both financially and emotionally. The are the least objective and have the most to gain from compromising the quality of their relatives‘ medical care.
Is that the state of the medical profession? Should care be administered on a bell-curve? The law and the medical profession should never be tailored to guarantee the maximum amount of freedom and rights to healthy and the strong. We turn to these institutions to protect the weak and helpless. Even the wishes of the patient themselves cannot be relied upon. An able-bodied person, flush with health, who declares “I don’t want to be kept alive by machines, that’s not really living,” might actually have a change of heart when he finds himself clinging to the last breaths they can take through a respirator. Those last moments of life, Professor Hanks said, might actually be the most precious thing in the world to the patients at that point.
But let’s get this clear. Motl Brody never asked to be put out of his misery. Motl’s parents begged the hospital and the courts to keep their son alive. Under a regime that defines “death” in loose terms, over the objections of relatives, a comatose boy was pursued to snuff out his life in the interest of conserving resources. This is not a dystopic horror story, this was an actual event that took place within the past year in the state of Maryland.
Let’s hope that we are never forced to discover for ourselves just how precious each moment can be, when Gd forbid, someone stands over us to cut our own connection to living as we stare helpless watching on.
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