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Friday, July 29, 2005

C.S. Lewis And Leslie Burke

The High Court in England ruled that Leslie Burke did not have a right to receive artificial nutrition and hydration (food and water):
Mr Burke suffers from cerebellar ataxia, a progressively degenerative brain condition that follows a similar course to multiple sclerosis. (actually, it destroys the brain's motor control centers.)

In an unusual move, Lord Phillips, the Master of the Rolls, issued a press release saying that "the fact that the appeal has been allowed does not mean that Mr Burke has lost".

Mr Burke will need artificial nutrition and hydration - known as ANH - when he loses the ability to swallow.

Lord Phillips explained that Mr Burke appeared to fear that ANH would be withdrawn before the final stages of his disease, when it would not be capable of prolonging his life. "If this is Mr Burke's fear, there is no reason for him to have it," Lord Phillips said.

"There are no grounds for thinking that those caring for such a patient would be entitled to or would take a decision to withdraw ANH in such circumstances."
The judges added that, "where a competent patient indicates his or her wish to be kept alive by the provision of ANH, any doctor who deliberately brings that patient's life to an end by discontinuing the supply of ANH will not merely be in breach of duty but guilty of murder"....

Mr Justice Munby ruled in the High Court that the patient had the right to insist on ANH but the Court of Appeal disagreed.

"A patient cannot demand that a doctor administer a treatment which the doctor considers is adverse to the patient's clinical needs. That said, we consider the scenario that we have just described is extremely unlikely to arise."
What a farce. See this article about a coroner asking for an investigation into men being starved to death in an English hospital.
A CORONER is demanding a public inquiry into claims that 11 hospital patients were deliberately starved to death. He believes that it could be Britain’s first case of forced “mass euthanasia”.

Peter Ashworth, the coroner for Derby, will open an inquest later this year into the suspicious deaths at the city’s Kingsway hospital....

There is now increasing concern across Britain about the way hospitals appear to be hastening the deaths of elderly patients. Police in Leeds and Hampshire are also looking into similar cases.

The 11 patients, all men aged between 65 and 93, died in the Rowsley ward for the elderly at Kingsway. A review of the cases, ordered by the coroner, found evidence that their deaths may have been speeded up by withholding sufficient food.
See this argument that the British government made against the lower court's ruling in Leslie Burke's favor:
This is the first time that the Department of Health has admitted what has long been obvious: that it stops feeding and hydrating patients, not because it is in their "best interests", but because it believes that it costs too much. The idea that it must be in a patient's "best interests" to be starved to death has always been nonsense. That, however, has not stopped health ministers and NHS officials from resolutely maintaining that particular fiction.

The Department of Health and the BMA refuse to recognise Mr Burke's right not to be starved and dehydrated to death because they fear it will create a generalised "right to treatment" - which in turn will mean that doctors will be obliged to provide medical treatment to terminally ill patients who want it, regardless of whether it will have any beneficial effect, and regardless of the cost.

Feeding and providing liquids to a patient too damaged to feed himself is not, however, medical treatment - any more than feeding a baby is medical treatment. It was categorised as such by the Law Lords in 1993, and for the sole purpose of allowing the judges to conclude that, in withdrawing food and liquids from Tony Bland (the Hillsborough victim then in a persistent vegetative state), doctors were not unlawfully killing him: they were merely not treating him. If doctors were not to be seen as licensed killers, those two activities had to be kept separate....
And "clinically appropriate" in the language of the NHS doesn't just mean treatment that will be beneficial to the patient:
THE National Health Service should not have to give life- prolonging treatment to every patient who demands it because that would mean a crippling waste of resources, the Government said yesterday.

A lawyer for Patricia Hewitt, the Health Secretary, said that a ruling granting a patient the right to request life-prolonging care had serious implications for the NHS.
Under current GMC guidelines, a competent patient could decide between treatment options offered by a doctor. “But the patient cannot require his doctor to offer him any treatment option which, in the doctor’s view, is not clinically appropriate or which cannot be offered for other reasons — having regard to the efficient allocation of resources.”
Doctors’ leaders said the precedent won by Mr Burke had created a minefield of unresolved issues over appropriate treatment and use of NHS resources. The GMC’s arguments — that the ruling is unclear and puts doctors in an “impossibly difficult position” of having to pursue treatments of no clinical benefit — has widespread support within healthcare.

Intensive care beds, where patients can receive lifesaving care such as ANH, cost £1,500 a day to run while high-dependency beds for patients who require close monitoring cost up to £800 a day.
In other words, it would be expensive to care for Leslie Burke, so Leslie Burke will be starved to death when he can no longer speak. He will be conscious and aware of his suffering. He now has several choices. If he goes to the hospital for treatment of an illness (pneumonia, kidney infection, etc) he risks being starved to death while he is conscious. If you doubt me, google "David Glass".

Finally, see this blog entry by a Catholic physician about N.I.C.E. and C.S. Lewis:
In C.S. Lewis’ novel That Hideous Strength an organization known as “N.I.C.E.” (National Institute for Coordinated Experiments) is empowered in Britain to solve various social problems without the bother of red tape. Unfortunately, N.I.C.E. is a demonic organization, engaged in social engineering, including euthanasia of the disabled, criminals, or simple “trouble makers” that will eventually take the input of beings (angels) from a “non-fallen” world to put right.

I wonder what Lewis would think of the modern day British institute that bears the same acronym (N.I.C.E.) of his fictitious organization?
I believe we all know what God thinks. Give to Catholic hospitals - that's my advice.

I don't know if this post is more depressing or outrageous.

I'll have to go with outrageous= mostly becuase of the hypocrisy. We don't starve dogs to death. If they want him dead, just do it. Kill him. Lets be clear as to exactly what it is we're doing.

The driver of the getaway car is just as guilty as the guy who shoots the guard and robs the bank.

Witholding ANH does not exonerate anyone from murder.
And note that while the NHS's guidelines mandate absolutely following an advance directive to withhold treatment, it does not find an advance directive to provide treatment binding.

Hypocrisy is the word.
The logical extension to government medicine is the rationing of health care. Oregon already is doing this. Votes on who should get what will always happen because there is no way the taxpayer can foot endless bills for prolonging life. Starving live old farts to death is but one solution. The Schavio solution is another. Then there is always "the final solution" of concentration camp fame. Can't happen? Absoutely can, and will.
Howard - I agree absolutely, and I have posted about this before.

Because all medical costs are paid out of the same bucket, and less necessary medical treatment (Viagra, e.g.) competes with more essential services, the majority's interest always supersedes the interests of the minority who desperately need essential medical care.

So the net result is that overall resources are diverted away from the critically ill to those who have a less urgent medical problem, and people who are severely disabled or chronically ill are quietly exterminated by one means or another.
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