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‘Futile’ Treatments and Autonomous Choice

PHL306 (2008) Paul Raymont

[The links in this note are all to short articles, each less than a page in length.)

Recall that one concern raised by opponents of euthanasia is that it will put us on a
slippery slope towards tolerating objectionable kinds of euthanasia. Brock replied that the
same objection could be raised against passive euthanasia, and that since we haven’t
responded by banning passive euthanasia, we should not take such considerations as a
basis for banning active euthanasia.

Be that as it may, there is no denying that hospitals have recently been ‘letting patients
die’ in increasingly controversial ways. In fact, there are now several examples of
involuntary passive ‘euthanasia’ in Canada and the United States.

In 1998, an elderly man in a Montreal hospital had to be put on a respirator. His family
said that this man was conscious and competent and knew that he would die in a matter
of weeks, but that he wanted to live as long as possible on the respirator so that he could
spend his remaining days with his family. In spite of this, a physician ordered that his
respirator be powered down. It was and the elderly man was given morphine. He died
over the course of fifteen hours. More about this and other Canadian and US cases can be
found in Wesley Smith’s article, ‘Futile Care: Who decides?’

In 2008, a more controversial case arose in Winnipeg, where 84-year-old Percy

Golubchuk was on a ventilator and feeding tube. His doctors believed that he had no
chance of improving and that his treatment was therefore futile. They wanted to
discontinue it and let him die. However, Mr. Golubchuk’s family said that this would
contravene his (and their) religious values; as Orthodox Jews, they believed that a person
must be kept alive as long as his heart is beating and he has some measurable brain
activity. Dr. Anand Kumar and two other physicians resigned from the hospital, stating
that to keep Mr. Golubchuk alive in his condition was tantamount to torture. Last June,
Mr. Golubchuk died (while on the life-support system) before a court could hear the case
about his treatment.

Wesley Smith also describes a US case involving an infant, Baby Ryan. Compare this to
the Texas case of Sun Hudson. Sun Hudson was critically ill and was removed from life
support against his mother’s will. Texas doctors were allowed to do this under a Texas
law (was signed by then Governor George W. Bush) which permits hospitals to terminate
treatment with ten days’ notice when the treatment is deemed to be ‘futile’. Another
controversial example of this law’s use was the case of Tirhas Habtegiris, a woman with
stomach cancer who was removed from a respirator against her and her family’s will.

Should patients have the right to any treatment that will prolong their life, or should
doctors have the power to discontinue treatment when they find it to be futile?