Involuntary Euthanasia by Proxy
A recent article in the New Zealand press talks about how a doctor placed a “Do Not Resuscitate” order in a patient’s file, against the patient’s wish. The patient’s son noticed the order in his mother’s file and countermended it. This kind of things concerns me a great deal when thinking of the issues of legalising physician assisted suicide.
Story Overview
We have here a case of:
- A woman who, "despite" a relatively low quality of life, is lucid enough to decide she does want to live,
- a son who supports that decision,
- a doctor who overrides that without talking with the people directly concerned.
This is what we know from the articles (see Hospital accused of acting like God and Do-not-resuscitate order shocks family for more):
- A Do-Not-Resuscitate (DNR) order was placed in an 85 year old woman’s file at a NZ hospital.
- The woman’s son has enduring power of attorney.
- The woman’s quality of life isn’t very good, but she is lucid, doesn’t have dementia.
- When the topic has been discussed with her, she’s always refused a DNR, as recently as a few weeks previously.
- DNR form was placed in the woman’s file, with an illegible doctor’s signature.
- There was a circle indicating on the form that this had been discussed with the patient and her family.
- The woman was unable to have that discussion, and the son is adamant nobody talked to him.
- The son "said he turned his mother’s oxygen back on himself, insisted that the morphine be cut back and that she be given fluids. The next day, she was sitting up in an armchair and was talkative."1
- A formal complaint was lodged with the hospital, who is investigating.
Euthanasia
That story scares me, especially when I think about the legalisation of physician assisted suicide. Euthanasia.
One of the things proponents of legalised physician assisted suicide always bring up is "informed consent". A patient could not have access to euthanasia without having all the information about their options. They also say that there would be safeguards in place to make sure that only the "right" people could be euthanised.
But who informs the patient, and their family? In most cases, it would be doctors or medical personel. I’ve already provided a bewildering number of statistics and studies clearly showing that doctors have a negative bias.
Who decides who the "right" people are that should be left to die? The very same doctors who have that negative bias.
Enters this particular story where the patient had been clearly opposed to dying, where the son was clearly wanting to have her mother given proper treatment, where proper treatment had the mother talkative and lucid and able to sit up, and where a doctor had decided that this woman should die.
Because signing that Do-Not-Resuscitate was saying, quite literally, "let her die". Against the wishes of both the patient and the family.
What If?
How often does this kind of thing happen in New Zealand hospitals? Too often, I suspect. How many people have already been left to die, against the family’s wishes, because they didn’t have a power of attorney and some doctor decided the patient wasn’t worth saving?
This is involuntary euthanasia by proxy. It is not exactly administering the "killing blow", but it is just as bad.
What happens if physician assisted "suicide" is legal? How many people will a doctor like this "help to die". It’s illegal to do so now, not to mention unethical to go against the family’s informed wishes. Yet it happens.
I hope you’ll understand why I’m really concerned about legalising physician assisted "suicide". I hesitate to use the term "open season" on people with disabilities and on the elderly, because many would perceive that as being too radical – hence dismissed out of hand. But really – think about it. How easy is it for doctors to decide a person’s quality of life is not going to be good enough, sign a Do Not Resuscitate order, without talking it over with the family, and the person dies?
I’m afraid. Very afraid. And so should you.