The UK is the land of good newspapers, and salacious ones, but lets leave that part alone. And each of the majors has a vivid voice: The Telegraph, more conservative; the Guardian, definitely liberal; The Independent, very liberal, while the Times has imploded; whatever it once was, it generally is no longer.
I bring this up because there was a good and thoughtful editorial in the Independent today about the Baby RB case, that has now ended with the father’s surrender to the doctors’ and his wife’s desire that life support be ceased. From “Hard Cases Make Good Law:”
Technology is enabling doctors to prolong lives that would until very recently not have been viable. Baby RB, the court heard, had a severe muscular malfunction and could not breathe unaided; doctors caring for him essentially agreed that his affliction made any future life he might have not worth living. Against that had to be set the potential fallibility of doctors, the possibly conflicting interests of the parents and the child, the principle of the sanctity of life, and the less edifying matter of the cost to the public purse.
Many of these same issues came into play in the long-fought case of Charlotte Wyatt, where the parents eventually won the right not to have treatment withdrawn without their say-so. Charlotte survived against the odds; now five years old, she is reported to be thriving in foster care.
In their separate ways, the cases of Charlotte Wyatt and Baby RB reached conclusions that were acceptable, if deeply painful, to all concerned. And the way things turned out the court’s intervention in both might now seem peripheral. Yet it is surely right that the arguments should be aired in this way. At a time of rapid medical advances and shifting public mores, the judgement of professionals needs to be tested – and the court is the place to do it.
I agree. That is why futile care cases have no place being decided in closed door star chamber settings of anonymous bioethics committees, where there is no public record, right to confront witnesses, or appeal.
But more needs to be said than in the editorial. What are the standards that should be applied when judging these difficult cases? I think the Independent, as liberal as it is, hinted at it—the sanctity of human life must count more than the public purse. That should mean no one is rationed out of life and no one pushed out based on quality of life judgmentalism. Rather, when in doubt or when there is a dispute, the default choice should be life.
Such a legal presumption would not institute rigid vitalism, but it would require those who want to force treatment to cease to prove clearly why a different decision should be made. Such a hurdle wouldn’t stop parents from deciding on what is best for their children, whether to cease or continue treatment—or children, similarly, what is best for their parents—but it would prevent bioethicists and other assorted would-be rationers from forcing patients and their families down a one-way street that they would not otherwise choose for themselves.
These are difficult times to be expensive for which to care. That is why we must walk the extra mile to validate the moral worth and equal humanity of such people before society and in law.
