I. How Much Was Sun Hudson's Life Worth? March 15, 2005, Sun Hudson was removed from life support in a Texas children’s hospital---despites his mother’s wish that he continue receiving care.
http://www.chron.com/disp/story.mpl/metropolitan/3084934.html "I talked to him, I told him that I loved him. Inside of me, my son is still alive," Wanda Hudson told reporters afterward. "This hospital was considered a miracle hospital. When it came to my son, they gave up in six months .... They made a terrible mistake."
The story is tragic. The infant was born with tiny lungs that never would have supported his body. The ventilator was a temporary measure, but even with a machine doing his breathing for him, it is unlikely that he would have survived. Many would say that death in this case was mercy—for the child.
However, doctors do not treat just the patient. They treat the whole family. Though there may be little or nothing that can be done for the dying, there is plenty that they can do for those will have to go on living. Parents with a terminally ill child often need time in order to come to terms with their child’s inevitable death. If they are not given that time, the grief process will be stuck forever at denial and anger---potentially wrecking another human life or lives.
What does it mean when the grief of some Americans---those with insurance, good jobs, higher educations---is treated as important, but the grief of others----minorities, the poor, immigrants---is treated as inconsequential or even selfish? We show respect for other human beings best when we acknowledge their human emotions. When we call their emotions "false" or "unimportant" we dehumanize them. We turn them into cattle to be raised and slaughtered at the whim of their masters. We create an underclass whose work can be exploited for subsistence wages and whose vote can be stolen without fear of criticism from the press.
Another little boy, Daniel Wayne Cullen II was in a similar situation. A preemie baby, he had been on a ventilator for over a year. The hospital wanted to stop his life support. The family objected. A local newspaper ran a story discussing how much such Neonatal ICU care cost---and how much of that cost was paid by taxpayers.
Of course the article has to deal with costs and who is paying the bill...
"But in another case, involving an 18-month-old Austin boy, Emilio Gonzales, the Austin American-Statesman reported that his treatment reached $1.68 million for 142 days in a hospital's intensive-care unit. The hospital said it expected to collect $389,000 in reimbursement from Medicaid and Supplemental Security Income. Because Daniel was in the custody of Child Protective Services, his care probably will be paid for by Medicaid."
The article just has to bring up that Daniel was in the custody of Child Protective Services. Why? What did any of that have to do with the fact the little boy pulled out a tube in his trachea, suffered brain damage and the ethics committee deemed him futile, with the mother winning a reprieve? Was it to make the mother look bad in the eyes of the public and therefore give justification for feeling she had no right to fight for the life of her baby? Only babies born to certain class levels and specifications are worthy of life?
http://www.dakotavoice.com/200706/R/20070611_CH.html There is an implicit message in these kinds of stories.
You can put a value on human life. And some lives are worth less than others. II.When Can a Conscious Adult Be Stripped of Her Right to Choose Between Life and Death? Since then, there have been several other cases in which Texas hospitals decided to remove patients from life support over the objections of family members---and in one case, over the objection of the patient herself.
Here is the story. Andrea, who is 54 years old, was a blue baby. She has had health problems all her life, but has led a full life. She was married and has a son. Recently she had complications from heart surgery.
After her latest operation she was put on a ventilator and life support, but was able to communicate through lip reading and writing. Her sister says she had no problem chatting and communicating. On Feb. 16th the doctor informed the sisters that Andrea had requested to be taken off life support. The sisters gathered on the 18th to their sister's bedside and Lenore asked Andrea if she wanted to be taken off life support. Lenore says that Andrea wrote, "I do not want to die. I want to live." The sisters informed the doctor of this. The doctor said that an ethics committee would meet and decide. A few days ago the sisters received notice from the ethic committee that they had decided to declare the "medical futility" of continued treatment for the patient.
http://blogs.chron.com/texassparkle/2006/04/what_value_is_life.htmlDoctors claimed that a woman on a ventilator (and therefore heavily sedated) indicated that she wanted to die. But after communicating with Andrea, her family insisted that she wanted to live. Despite this, a medical ethics board was ready to pull the plug.
After the public learned of Andrea, the hospital decided to reconsider their decision, and she went on to die from other causes. But what would have become of her if her family had not gone to the press? Would a conscious woman have been sentenced to death over her own objections? This violates one of the most basic medical ethical principles of all---autonomy. Autonomy is the right all competent adults have to be informed about their medical condition and about the various treatment options so that they can make a decision. The principle of autonomy is not respected in all countries. In Japan, for instance, the terminally ill are often not informed about their diagnosis. However, in the United States it is right up there with "do no harm" as a basic ethical obligation of physicians. So, why did a medical ethics panel have to feel the weight of public pressure before it acknowledged Andrea's autonomy?
III. A Death in the Family If the patient is not competent or is a child, then a family member is empowered to make medical decisions. Medical ethicists sometimes have to veto the wishes of family members in cases in which the family’s decision violates the will or best interest of the patient. However, most family members want what is best for their loved one. And, if a doctor whom they trusts tells them that further care is futile, they will accept this. This is one time when a family doctor can do a lot of good. If you know that the physician took good care of your mother in life, then you trust him or her to take the best possible care of your mom in death.
But what about people who do not have insurance and who can not afford a family doctor? What if some strange physician you hardly know comes in to the room and says “A committee has decided to pull the plug. You have 10 days to find another hospital”? There is a good chance that this family will always believe that their loved one was denied care because he was 1) poor or 2) Black or 3) chronically disabled. A tragic death will become even more tragic. A family’s anger and grief will intensify. And the public—especially the poor and minorities and immigrants---will hear about these stories and their fears of the U.S. health care industry will grow.
Here is what Andrea’s family wrote at DU:
The fact that we had to fight this battle is both
frightening and a sad commentary on the so-called
"ethics" now being practiced in medical facilities in
this state. The battle for life is a difficult one,
in the best of situations, but when a family is put
through what we had to go through at such a time, it
is especially agonizing.
We wish so much that we could have spent more time at
our sister's side, when she was living and fighting
for her life, rather than having to visit our
attorney's office, give interviews to radio and
television stations to let the public know of the
atrocity about to befall Andrea, and literally stand
outside the hospital and beg them not to kill our
sister. In attempting to deprive Andrea of the most
basic of her human rights--life--St. Luke's Hospital
managed to deprive her family and her of that which is
most dear to us all, when we are faced with the death
of a loved one: a proper goodbye.
How, in the name of God, anyone can call putting
someone to death when they are at their most helpless
and begging for their lives "ethical," we cannot
imagine.
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=364x1128570IV. Republican Death Panels Note that the above cases occurred in Texas. That’s because Texas has an “Advanced Directive Act” signed into law in 1999 by then Governor George W. Bush, which allows a hospital to stop care if it deems that care is futile. The law gives family members 10 days to find another hospital willing to treat the patient---which may be impossible if there is no insurance to pay the bills.
Dr. Ross says that under the law, some dozen times hospitals have pulled the plug against the family's wishes. She says more often than not, the law is used against poor families. "The law is going to be used more commonly against poor, vulnerable populations. If this family could pay for a nurse to take care of the boy at home, we wouldn't be having this conversation," she said.
http://edition.cnn.com/2007/HEALTH/04/25/baby.emilio/index.htmlTirhas Habtegiris was also uninsured when her hospital decided to take her off a ventilator. She had terminal cancer and was going to die, but her family members said that she was conscious and that she wanted to see her mother again one more time. Unfortunately, Tirhas was a legal immigrant from Africa, and 10 days was not enough time for her mother to get to this country. So, her life supports were removed over her family’s objections.
Her family feels caught in America's health insurance crisis.
"And it's kind of a shock to me too to experience this in this country. It's the richest country in the world. Very sad," Salvi said.
Experts say there are very few charity beds for ventilator dependent patients in this state.
http://web.archive.org/web/20060106045601/http://www.wfaa.com/sharedcontent/dws/wfaa/latestnews/stories/wfaa051214_lj_african.bb0e76d.htmlOccasionally, a Texas politician will vow to fix the loophole in this law which allows hospitals to decide instead of patients and families. However, ten years later, the law is still in effect. Since Texas has been under the control of the Republican party for all these years, this is a
Republican approved death panel.As goes Texas, so goes the rest of Republican America. Arizona is now rationing care for those on Medicaid. If you are an adult in need of certain transplants, your options are either die or move to another state. Arizona is under Republican control. Indiana is denying coverage for a transplant with a 50% chance of success---and Indiana is a red state.
http://news.yahoo.com/s/yblog_thelookout/after-budget-cuts-indiana-baby-denied-life-saving-treatment#mwpphu-containerDo I have to point out the irony? The party that gives lip service to Right to Life is the party of selectiveeuthanasiaa. Why? What do Republicans gain from this kind of hypocrisy?
V. Tuskegee I can not discuss this topic without mentioning the Tuskegee Syphilis Study. Southern African-American men with syphilis were followed for many decades so that doctors could study the long term effects of untreated disease. Never mind that doctors already knew the consequences of advanced syphilis---brain disease, heart disease. Even after penicillin was introduced in the 40s, these men did not get treated. This “study” of a disease which had already been well studied all through the 19th and early 20th century continued until a whistle blower turned the doctors in and (a Democratic) Congress held hearings.
The suspicion and fear generated by the Tuskegee Syphilis Study are evident today. Community workers report mistrust of public health institutions within the African American community. Alpha Thomas of the Dallas Urban League testified before the National Commission on AIDS: "So many African American people I work with do not trust hospitals or any of the other community health care service providers because of that Tuskegee Experiment" (National Commission on AIDS, 1990).
http://www.tuskegee.edu/global/story.asp?s=1207598The poor and minorities are less likely to become organ donors, because they are afraid that they will be “killed” by hospitals and their organs stolen. They are less likely to accept that a diagnosis is terminal---even when it really is---because of a deep seated fear that care is available but is being withheld in their case because of who they are.
Imagine that you are already suspicious of the "greatest health care system on earth" because of scandals like Tuskegee and the forced sterilization of minority women. Imagine that your father died after being sent out of a crowded teaching hospital emergency room with a diagnosis of "indigestion" when he really had a heart attack. Imagine that your mother has had a stroke and she is on a ventilator. When some doctor you do not know walks in, shakes your hand and says "Your mother isn't going to get any better. We're going to take her off the ventilator" how would you feel? Would you wonder if this is because she is still too young for Medicare? Would you wonder if she is being taken off tventilatortor to make way for some white person with insurance? What if the hospital staff treats your concern as irrational--a waste of their time? What if they leak stories to the press about how much your mother's unfunded care will cost tax payers?
The right wing calls these folks greedselfishish. They attempt to blame our health care crisis on them, just as they attempt to blame the mortgage crisis on folks who have lost their home. They tell the Republican base
Your health care would be better if you did not have to pay for the health care of all those filthy, lazy ______s, hoping that scared, desperate America will exclaim as one
Yes! Our lives would be so much better if not for the ______s. And America is divide and conquered once again. That is why Republicans create death panels.
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