by Christian Ohnimus Wednesday, October 30
Canada has death panels and that’s a good thing – or so says Slate writer Adam Goldenberg.
Goldenberg outlines last week’s Canadian Supreme Court decision which ruled that 1) doctors cannot act contrary to the consent of substitute decision makers (usually family) and 2) that, while doctors cannot, a government-appointed tribunal can overrule the family’s decision and make healthcare decisions on behalf of the patient, even in matters of life and death. These tribunals then are “death panels” and thank goodness for them too. Without them these disputes would go to court and can last months or years. The tribunals can act with unilateral discretion and that is efficient.
Because, ultimately, Goldenberg’s argument on why death panels are a “good thing” boils down to efficiency. These “(technically) alive” people are taking up valuable hospital beds and, since their life is merely a technicality anyway, aren’t we all better off with a quick decision that can get them out so the next sick person can roll in? This too is also in the patient’s best interest of course. As Goldenberg puts it, “prolonging his life would entail the risk of infection, bedsores, and organ failure. When recovery is out of the question, in other words, there may be fates worse than death.” It’s a win-win for everyone.
Really though, much of what Goldenberg says makes sense and yet something just doesn’t feel quite right. When doctors and family members are in irreconcilable dispute shouldn’t some third-party become involved to help settle the matter? Shouldn’t we ease patients’ suffering and not prolong their death? The answers are yes but Goldenberg’s perspective is wrong: he is preoccupied with death and efficiency when he should be concerned about the person. Goldenberg seems to almost overlook the patient in his affirmation of his so-called “death panels.”
How we deal with death is a moral matter and the “morality” that Goldenberg appeals to is efficiency, which is to say utilitarianism. Mere utility, however, is nothing more than the absence of any moral system. In the absence of a moral code it all just becomes numbers. Instead, we must judge the decision-making process not by its speed but by its ability to do what’s best for the patient. Instead of seeking to reach a decision quickly for sake of efficiency or deciding that death is somehow desirable because living is “worse”, decision-makers must weigh each situation and choose that course of action which is best for the patient. If it is determined that recovery is impossible the goal should not be to save the patient from life but to allow them to die while making their last moments on Earth the best possible. In healthcare we call that palliative care and, with appropriate pain management, good hygiene, frequent re-positioning, and all around high quality nursing care far more can be done for the sake of the patient and their family to bring them peace. If tribunals approach patient cases with the dignity of the human person in mind then we would hardly be able to call them death panels. It means that no one’s death will be hastened but it also means that they will not be forced to suffer needlessly with inappropriately aggressive treatments or through neglect.
Goldenberg’s final paragraph includes the following, “Modern medicine increasingly allows us to extend life indefinitely, and so the question is no longer whether we can “play God,” but when, how, and who should do so.” I give him marks for being bold because his statement is so blatantly false. We cannot extend life indefinitely and we cannot be like gods who control life and death. Everyone dies and it’s not usually planned. Our job as healthcare professionals is not to be the masters of life and death but to take each patient where he or she is at and provide the highest quality care possible. Sometimes we can save a life and, when we cannot, it is our solemn duty to make our patient’s passing as dignified and peaceful as possible. We cannot preoccupy ourselves with abstract conceptions of Life and Death divorced from the patients involved. After all, there are people to care for.
Christian Ohnimus is a registered nurse in Grand Rapids, Michigan. He holds a Bachelors of Science in Nursing from Franciscan University. He is a contributor to The Porch and The Catholic Renaissance.