Sujet: tothesource Right to Die
De: tothesource
Date: 24 Aug 2005 22:22:07 -0700

August 24, 2005    

Dear Concerned Citizen,

by Wesley J. Smith

Terri Schiavo was dehydrated to death because she had supposedly told her husband and others that she would not want to live as an incapacitated woman. In other words, her food and water were taken away to honor her personal autonomy.

So, that must mean that seriously incapacitated patients who want to live also must have their desires respected, right? Wrong. In health care, patient "choice" is increasingly becoming a one-way street.

There are two kinds of "medical futility," and the difference between them is crucial to understand. If a patient or family requests care that will not work, it
is physiologically futile. As an extreme example: If I were to request that my appendix be removed to cure an earache, the doctor would--and should--say no. Why? The surgery would do nothing to cure my earache. Doctors can and should refuse physiologically futile care.

But this is not what Futile Care Theory is all about. Rather than refusing requested treatment because it will not work, the care is declined because it will. In other words, it is the patient--rather than the treatment--that is actually being declared to be futile. Thus Futile Care Theory involves personal values more than it does professional medical judgments.

According to articles in medical and bioethical journals, here is generally how bioethicists intend to impose Futile Care Theory on patients and their families in hospitals around the country:

  • If there is a treatment withdrawal dispute between patient/family and doctors, the case will be referred to an internal hospital ethics committee "for adjudication."
  • The committee members will hear from the doctors, family, nurses, social workers, and others involved in the case, as well as the patient or family.
  • If the committee decides that the care should be provided, it will continue. But if it decides that the treatment should be withdrawn, life-sustaining care will no longer be provided in that hospital--even if another doctor volunteers to provide the care.
  • At that point, the patient or family must find another hospital willing to provide the care. If that can't be done, the treatment will be withdrawn and the patient will probably die.

Nobody knows how many hospitals around the country have adopted Futile Care Theory as part of their end-of-life care protocols. But clearly, many have. An article published in the Cambridge Quarterly of Health Care Ethics in 2000 [Vol. 9, # 4, 2000, pp. 524-531] found that of 26 California hospitals surveyed, 24 accepted Futile Care Theory. Of these, all but 7 gave the final decision over withdrawal of wanted care to doctors or ethics committees rather than patients and their families.

If "choice" or patient autonomy is the foundational ethic of health care, none of this makes sense. But if the actual goal is the death of certain categories of "biologically tenacious" patients (in the words of one prominent bioethicist), then Futile Care Theory is perfectly logical.

These developments signal the creation of nothing less than a new medical ethic in which certain patients have a "duty to die", a concept explicitly under active consideration in contemporary bioethics discourse.


We received these letters from C. and J. S.:

There is was again. The statement that "exclusion of religion from politics and the intellectual exclusion of intelligent design from biology are part of a larger, more comprehensive, well-planned secularizing project." Can we step back from the paranoia ledge just a bit. - C.

I just feel this is much ado about nothing. If you are of a religious/spiritual nature then you know that God created us and it is not for us to understand this profound miracle. Darwin's Theory of Evolution does not in any way threaten my belief in God. - J. S.

Their messages got us thinking. Maybe we need to do a better job of explaining ourselves. That's why we've commissioned a tothesource series dealing with this well documented, "larger, more comprehensive, well-planned secularizing project", to show that it is concern and not paranoia that motivates us and why it should also concern you.

Hey friends, before you call us "paranoid", contentious, anti-scientific, or say the article is "ignorant", etc., wouldn't it be more fair to carefully read the article you are critiquing? tothesource is in fact trying to save science from the contamination of fundamentalist Darwinian COSMOLOGY. You advocates of "pure" science should love us and fully endorse this project.

That is the most ignorant article I've ever read. Christians have every right to believe in evolution and that God planned it. Children who must by law attend school should be taught the scientific theory that is based on the most up to date scientific research. You cannot insist that children who have not been brought up to believe in the One God be taught that the world was created in seven days by a power they have never heard of. This is a democracy! Actually, it would make science classes a whole lot easier to teach! By the way, people who lived in the days when the Bible was written used we need to forbid Calculus in the high school as well? - D. O.

Your debate assumes the extremest of positions on behalf of the scientific community. To assume that all scientists are secular fundamentalists is as misleading as to assume that all Christians are literal fundamentalists. Darwin, after all, was concerned with the "Origin of species" not the origin of life. There is no inherent conflict between the concept of intelligent design (in its broadest understanding) and evolution as a workable scientific template. Please quit making conflict happen where none really exists! - J. F.

The theory of evolution has stood up to rigorous scrutiny. Treating it as "one theory among others" only embraces ignorance and transmits that ignorance to our children. Every school in America must preserve the integrity of the science curriculum by teaching of the theory of evolution as a core component of human knowledge. God has given us the physical laws which govern our universe. God has also given us human minds capable of critical thought and reasoning. The proponents of "intelligent design" commit the ultimate act of hubris when they argue that we should reject our gifts and deny the clear evidence of what God has created. Any failure to use our minds for scientific inquiry is clearly a rejection of the will of God. - C. Z.

Other responses to Who picked this fight?:

Finally! It's about time someone took the time to explain the distinction between Darwin's evolutionary theory and Darwin's cosmology. Perhaps now the shouting match will cease and productive conversation can take place among thoughtful people. Questioning Darwin's cosmology does not make someone "anti science", if anything, it's more in keeping with the concern of science to keep questions of science and faith separate. - D. S. T.

It is sad that our society is so naive to believe that religion and politics would only become better if combined. Why do you think that our founding fathers were so adamant about keeping them separate? Because they wanted their new government and country to fail? Of course not, it was because they had to seek out, fight for, and found a new society because they had just come from a place where people were having to risk death to get away from the religious oppression of their government. So why would anyone want to risk allowing the state to rule over religious matters? If you look back in history, the combining of the two has ALWAYS led to persecution. Narrow minded individuals can only conceive of the betterment of society through intermingling of church and state. In a perfect world perhaps that could happen, but not in this power-hungry and greedy world that we live in. - C.

Great article on the evolution "science" versus intelligent design conflict. Keep up the good work. J. S.

Darwinism was totally disproved in 1972 when they discovered the anti-mutation gene. So many people think one celled amoeba started the whole thing. Not so. Darwin stated that "there is no proof for a mutation from one animal into another". If there was a missing link there would be millions of bones, traces etc . People get this wrong so much. They are not teaching Darwinism is Canada, only referring to it as a theory that was disproved when they started the genome project. - H. M.

Interesting that you quote Einstein when it suits you--these are probably the only things he said that you agree with. - Rev. J. B.

I wish you folks would put in your email "Subject" line, who you are. E.g.,: Subject: tothesource; Who picked this fight? Due to the proliferation on web attacks/hacking, I am reluctant to open email that does not identify itself. Please consider this as you move along. Speaking of "…moving along…", Thank You for the informative newsletter. Good Job! - A. J.

We cannot lay down morality on the basis of religious stories that were written in ancient times. Life is dynamic and it belongs to the System of Life to which everything in the world of creativity belongs. Religions have become a moral problem due to their insistence on faiths for the expression of spirituality. - S. K.

John Polkinghorne is a theistic evolutionist, and not one to promote as a man who follows scripture according to Genesis 1. Australian scientist, John McKay, a geologist and christian debated Polkhorne in Cambridge, and BBC commentator Roger Phillips refereed the debate at Liverpool Cathedral. It was professionally filmed, and Mckay won the debate. I will include the link Click under DVDs, located under debate, the education debate. - B. B.

Responses to other tothesource articles:

Regarding the Aug 10th Experimental Family article: I really hope that my new husband and I can create a home for our blended family of 5 children (2 are grown, 2 are teens, one is 8), not just to love and nurture them, but to show them that it was a courageous thing for us to do. Instead of staying in dead relationships that were not going to get better with counseling and prayer, we both found our way out of bad marriages and into the light of something that gave us both hope again. The details are unique to us but told over and over again in American society. Often it is the best thing for children to be raised by their biological parents, and divorce hurts everyone, but there is a saying that those of us who live in a world outside the box understand better than those who live with absolutes: "When the pain of staying outweighs the fear of leaving, change happens." I didn't want to be divo rced, but I couldn't continue the way it was. Short of physical abuse, I think most divorced people share this common idea: something had to change; it just couldn't go on as it was leaving only loneliness in its path. I will err on the side of love. I will be the best mother and step-mother I can be-----and wife and daughter and sister and friend, full-time working, college-educated woman. I was an irritable, unhappy, frustrated mother in my other life, family in tact, yes, but at what cost? Instead of knocking all divorced people and single mothers, why don't you try to find some good in those of us who have been tested in the fire. I've been to hell and back. Hell wasn't fun. Life is good again. - C. G. M.

Could you provide the source of the quote by Richard Lewontin? - S. C.

Sure! Here it is.

NY Times Book Reviews
The Demon-Haunted World: Science as a Candle in the Dark by Carl Sagan

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Medical Futility in End-of-Life Care
The Culture of Death: Who Will Decide When You Should Die?
License to kill Hospitals reserve the right to pull your plug
Medical Futility in End-of-Life Care
We live complex lives. We strive to sort out priorities that sometimes conflict or seem incompatible. A moral framework is needed to help us understand the reality around us. Our Judeo-Christian heritage provides a framework to help us comprehend the choices we make and the conflicts that arise over them. It is not only the main source of our spiritual values, but also many of the secular values we depend on.

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  Wesley J. Smith
Smith is an attorney and consultant for the International Task Force on Euthanasia and Assisted Suicide. His book Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder (1997), a broad-based criticism of the assisted suicide/euthanasia movement was published in 1997. His book Culture of Death: The Assault on Medical Ethics in America, a warning about the dangers of the modern bioethics movement, was named One of the Ten Outstanding Books of the Year and Best Health Book of the Year for 2001 (Independent Publisher Book Awards). Smith is an international lecturer and public speaker, appearing frequently at political, university, medical, legal, disability rights, bioethics, and community gatherings across the United States, Great Britain, Canada, and Australia.
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