PBS Frontline on euthanasia

PBS Frontline recently featured a show about how terminally ill patients and their families face death. Medical science today can keep virtually any body “alive” for years – even after vital organs have ceased to function. It is a complex issue because – in addition to the philosophical questions about what it means to be alive – there are questions about the economic sustainability of the Pro-Life positions. Estimates for yearly costs of keeping people in vegetative states alive are in the billions. These are people who have exhausted every possible treatment, whose condition is worsening and can expect no cure. According to CBS 60 Minutes, which earlier this year aired a show similar to Frontline’s, in 2009, “Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients’ lives.”

Before I criticize this as “wasteful” spending, as some have done, I want to acknowledge the fact treating the terminally ill, doctors do learn a lot about the diseases that affect them, and that knowledge may be applied at some point in other cases to save lives. The Frontline program focused on patients for whom further treatment would neither further benefit the patient or research, and yet many clung tenaciously to life and asked to be kept alive at all costs.

However much I would admire these patients were they to say, “No, don’t spend anymore money on me. Spend that money on children with rare and curable diseases,” I also empathized with them for their will to live, or rather their fear of dying. I was very disturbed watching this program, when the doctors and the families insisted that the patient make the decision to stop treatment. “Tell us what you want us to do,” They would say, “If you stop breathing do you want us to resuscitate you?” “Do you want us to remove the tubes so that you can die comfortably?” They may have been “asking,” but their preference was quite clear. I could see that the patients were weak and frightened and felt abandoned. Most of them cried. How dare we expect them to be the heroes and give up their lives, such as they are, for the sake of others? I think it’s cruel, and I think these decisions should be left up to professionals.

What was missing from these hospital bed scenes was mercy. Mercy is something that can’t be written into any law or code of ethics. Mercy often involves the transgression of what, in other circumstances, might be considered the right thing to do. Our current laws give individuals the right to ask to be taken off life support systems, to refuse further treatment and to give the “do not resuscitate” order. In the case of patients who are not conscious, our current laws give the family the right to make these decisions. But is this really humane? To be truly merciful to these patients, who are frightened and without hope, would be to lie to them, telling them their diseases have been cured, while slipping them a fatal dose. In no way would I advocate any kind of legal adoption of such a practice. But the truth is that this is what is done for terminally ill people all the time. This is so much more humane that trying to coerce them into pulling their own plugs. How can a doctor ask the parents of a brain-dead child to give the order to remove the machines? What parent can reasonably be expected to give up hope? Do we really want the parents to live with the memory that it was they who made the decision to allow the child’s body to stop breathing? Why not just remove the machines and say to the parents, I’m sorry we did everything we could?

Again, I’m not advocating that we give doctors such powers that only they have the legal right to decide when a patient lives or dies, but I do want us to consider what we do to some patients and the families when we put the burden squarely on their shoulders. There are some who are comfortable choosing death as a release from suffering, but many are not. As medicine ever improves its ability to keep alive bodies for indefinite periods of time, we have to reexamine this code of ethics we have that burdens the individual and put the burden of that decision, not on doctors, but on society as a whole.

See more at Naked Singularity

You can watch the Frontline program online at: http://video.pbs.org/video/1639625115/

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