The Ethic of Death Is Not a Work of Fiction

Judie Brown
June 7, 2011
Reproduced with Permission

News reports can often be misleading. But recent news from the nursing profession and the consequences of what is being recommended leave no room for doubt. Something has gone terribly awry.

Nurseweek recently published an article entitled "Ethics Committees 101." Among the statements made in the article is this one: "Nurses also should understand their own value systems and set them aside when needed, because other considerations in an ethics case may trump personal beliefs."

In other words, even when a nurse might object to participating in an action that would prematurely end the life of a patient, she should forego her conscience - her ability to define good versus evil - and literally go with the flow. Apparently the new ethics-by-committee standard translates into a Pontius Pilate approach to health care. As long as a nurse is willing to go along with committee recommendations, everything is fine.

Professor of Nursing Lois Robley, author of the 2009 article, "POLST Sweeps the Nation" shares her perspective in the same Nurseweek article:

Ethics committees also examine broader, organizational issues and policies, not just situations focused on a single patient's care. For more than a decade, Robley has served on the steering committee that oversees ethics panels at the five WellStar hospitals. Her committee recently has focused on a campaign for getting advance directives noted on patient charts, and reorganizing and clarifying the hospitals' POLST, or physician order for life-sustaining treatment.

The problem with this is that POLST can be a totally subjective recommendation based on interests that have little to do with easing patient pain or helping a patient live out the rest of his days with a modicum of hope and love. The POLST recipe can be very dangerous in the hands of an ethics committee. Who takes the responsibility for a consensus recommendation? I think we all know the answer to that one - nobody.

Dr. Elizabeth Wickham has accurately written,

The POST/POLST form builds on the incorrect premise that a person has an unqualified right to refuse any medical treatment.

The Catholic Church teaches that because life is a gift from God we have a primary obligation to show reverence for it at all times …

By euthanasia is meant an action or omission that of itself or by intention causes death. No one should be deprived of basic care. No physician or health care professional should encourage a patient to violate his moral obligations.

An excellent example of this sort of thinking is contained in an end-of-life document called "Five Wishes." As moral theologian Basil Cole writes in his analysis of "Five Wishes":

There is a section in this document that asks a future patient the following: "If I wish to omit life-support treatment, I write this limitation in the space below," which is very dangerous. The problem with this request is that most of us are not good doctors to be able to give such directives. As a result, it would be possible for us to die based on poor care that we authorized in the first place. We never can know when new procedures for curing may be discovered, which if used, could give us years of a productive life. Finally, it is possible that a poor and ambiguous sentence or two in this document could be used by a hospital to force us out so that the hospital can have the bed for another patient.

When the hospital's ethics committee examines patient documents with a preconceived notion of whom to treat and when to recommend ending treatment, end-of-life care documents like "Five Wishes" cannot be helpful.

Writing about caring for those facing death and the ethics surrounding this, Wesley J. Smith has been warning Americans for years about policies like those noted above. His insights into so-called "futile care" assessments bear repeating and thoughtful discussion in this age of Obamacare and dwindling health care resources. Smith cautions, "Quality of life futile care theory imposes bioethical/hospital/doctor subjective values on patients and their families. Care isn't deemed futile because it doesn't work, but because it does. Hence, it is the patient being declared futile."

If human dignity is violated in hospitals treating the ill in the same manner it has been debased prior to birth, those vulnerable because of an illness or disease are in big trouble. And apparently trouble is brewing across the nation.