Golobchuck Case: The Arrogance of Futilitarianism: A Deadly Combination of Anti-Humanism, $, and the Imposition of a Duty to Die

I have warned that “personhood theory” will lead to terrible oppression of so-called human non persons. It allows cloning for the purpose of treating created human organism as a corn crop. It permits us to dehydrate people to death based on their once having made vague statements about not wanting to live with profound cognitive disability, and it is the ideological basis for denying wanted medical treatment that sustains life. In short, it is the prescription for medical oppression in which people deemed to be without sufficient cognitive capacities become almost the equivalent of the dead and the value of their lives is stripped from them like the medals from a Foreign Legion soldier being kicked out of the corps. At that point, their only remaining task is to die and get out of the way—or perhaps become fodder for experimentation or organ procurement. But don’t say that these futilitarians aren’t compassionate: They will provide comfort care as they make sure you die from their medical neglect. (Big of them.)

Lest you think I overstate, lest you think I caricature those with whom I disagree on this issue, check out this opinion article in the Winnipeg Free Press from a bioethicist named Arthur Schafer in support of forcing Samuel Golobchuk off of life support. From his column:

Inevitably, doctors are the gatekeepers for patient access to medical resources. You can’t obtain restricted medicines unless a doctor is willing to write a prescription; you can’t gain admission to hospital unless a doctor decides that you will benefit thereby. There is a scarcity of intensive care beds; so, to admit or keep patients in the ICU who cannot benefit is to rob others who could benefit. Put simply, one person’s provision is another person’s deprivation. It’s unethical to waste scarce life-saving resources.

If a patient will never again know who or where he is, as appears to be the case for Golobchuk, then to artificially prolong his breathing seems at best a waste of precious ICU resources and at worst a cruel ordeal for the patient. Doctors and nurses are not simply technicians providing marketplace services to customers. They are health-care professionals who are bound by the ethical obligation “first of all, do no harm.” When a patient has irreversibly lost self-awareness, then using medical high technology in a vain attempt to resist death is often experienced by doctors and nurses as both unprofessional and deeply demoralizing. Physician integrity includes the right, even the duty, to say “no” when treatments offer no genuine benefit to the patient.

Forget for the moment the many times doctors have been wrong about people never regaining consciousness. Schafer is the one de-professionalizing medicine. A plumber can refuse to unclog a pipe, but a doctor has no right to abandon his or her patient. Moreover, Schafer wants doctors to impose their value judgments—as instructed in continuing education clases by bioethicists like Schafer—that the burden of treatment isn’t worth the benefit of continuing to live. But that isn’t a medical judgment, it is a value judgment that we have always been told resides with the patient and family. Moreover, the treatment isn’t being stopped because it doesn’t or might not work but because it does or will—and hence it is not really a “vain attempt to resist death,” but a potentially successful one. And thus it is really the patient who has been declared futile.

Schafer says that staying alive when that is what the patient wants offers no genuine benefit to the patient. He only has the right to make that claim for himself, not for Mr. Golobchuck, you, me, or anyone else. You are watching the redefining of the ultimate purpose of medicine before your very eyes. It isn’t keeping patients alive who want to live, it is treating those who can be cured and reserving the right to refuse service to those who probably won’t improve.

This is what socialized medicine—and its’ private equivalent the HMO—creates. Medical futility is health care rationing that pits one cadre of patients against others, leading to division and discord. It is the end of trust in medicine because if you are too sick or profoundly disabled, medicine wants little to do with you.

Finally, if Futile Care Theory prevails, what in the world makes anyone think that the forced removal of people from wanted treatment will stop at the ICU? People who only need feeding tubes will soon be dehydrated (if they are not lethally injected first), and care will be rationed based on other criteria. For example, as reported in my books, I once asked a futilitiarian what would come after futile care, since cutting off the dying would not save a lot of money. He immediately said restricting “marginally beneficial care.” I asked for an example. He responded, “An 80-year-old woman who wants a mammagram.”

Be afraid. Be very afraid.