Playing God in the Great White North.The Manitoba College of Physicians and Surgeons has issued a
statement endorsing the right of Canadian physicians to withdraw "life sustaining treatment" from patients over the objections of the patient's family."Life sustaining treatment" includes any treatment that sustains the life of a patient without curing the underlying condition. Thus, "life sustaining treatment" might include providing food and water, but might also include hygiene and shelter.
The physician's duty with respect to consulting with other doctors and the family varies on whether the "minimum goal of life sustaining treatment" is reasonably achievable. The "minimum goal" is defined as the "recovery of cerebral function" to a point where the patient is aware of the self or the environment.
A physician can decide to withdraw or withhold life sustaining treatment of patients for whom the minimum goal is not reasonably achievable. If that decision is made, the physician must consult with another physician and the family, however, if the conultation with the physician results in a concurrence in the decision to withhold or withdraw treatment, then the treatment can be withheld or withdrawn notwithstanding the family's objection, although the physician must give the family written and verbal notice of the time and date that treatment will be withheld.
A physician can also withhold treatment for patients who might achieve the "minimum goal" if the physician decides that secondary effects, such as pain and suffering, outweigh the benefits of achieving the "minimum goal." In that case, the family's objection to withholding or withrawing treatment requires the physician to transfer the care of the patient to another physician.
The College makes the following claim in its Statement:
3. The Manitoba Courts have recognized that physicians have the authority to make medical decisions to withhold or withdraw life-sustaining treatment from a patient without the consent of the patient or the patient’s family.
Baldly stated like that, that seems a most unusual and far-reaching proposition.
It may not be correct, however, as noted in
this Volokh Conspiracy" post, although one has to wonder about what is motivating the Manitoba College to grab of god-like power over life and death.
Perhaps
Mark Shea has an answer:
The Manitoban College of Physicians has recently come out and said that doctors have the right to euthanize anyone above the wishes of the family.
Nothing's certain, of course, but given the *enormous* pressure that us aging members of Generation Narcissus are going to exert on the social system as we start getting old and sick, my money is on the rising generation learning the valuable lesson we taught them: Kill the Inconvenient. Barring something unforeseen like a car accident or a bullet from a torture zealot, I think the odds are very high that I will be murdered in my hospital bed at the order of a bean counter in order to cut costs. I'm at the tail end of Generation Narcissus (born 1958). Long before I get old and weak, the main demographic bulge will have worked its way through the collapsing Soash Security system and cost enormous amounts on a workforce feeling the full effects of demographic winter. Something will have to give, and it will not, in all likelihood, be the fallen human heart. So we Baby Boomers will reap the harvest of death we have sown in our covenant with death. Initially, euthanasia will be sold as "choice". Then it will become peer pressure. Then duty. And finally it will become obligation under law.
Note, incidently, how the "minimum goal" of self-awareness is ultimately a red-herring. Doctors can decide to remove life-support for patients who can be returned to awareness if the doctor decides that negative consequences justify death. Right now, the negative consequences might be "pain and suffering" but what does that mean? After the imperialism of logical development works its magic, could pain and suffering include the psychological distress of living a "life not worth living"?
How about cost and expense? How about efficient use of limited resources?
Care to bet against it?
Likewise, doctors who decide that the continued care of patients capable of the "minimum goal" is not worth the effort are to transfer their patients to other doctors. This seems like a concession in the direction of erring on the side of life, but how long with that policy stay in effect?
The fact is that such a policy should not be necessary - Once upon a time the Hippocratic Oath set the policy of doing no harm to any patient.