Protecting the Medically Vulnerable

PROTECTING THE MEDICALLY VULNERABLE:

PRO-LIFE PRINCIPLES….

 by Fr Jim Whalen

2000, Issue 2

     Protecting vulnerable persons has been supported, in the past,  by a fundamental medical principle: Do No Harm.  This has been enshrined in the Hippocratic Oath and in Medical Ethics. Situation Ethics challenges this position and we are all aware of the resulting legislative consequences as evident in euthanasia, mercy killing, and assisted suicide.  Among the most vulnerable, we find the chronically ill, the terminally ill, the severely mentally disabled and the severely physically disabled, all of whom are classified as ‘medically vulnerable’.

        Inherent in the teachings of Fletcher, Kohl and other Situation Ethics adherents is the false principle that proportionate reason should govern medical decisions for the medically vulnerable.  This implies that “some human beings have fewer moral rights to care and medical treatment than others, and that directly willing death is morally unobjectionable in some cases”.1

        Many decisions have been made based on such reasoning.  This has resulted in legally-endorsed assisted suicide and non-voluntary mercy killing.  In the 1982 case of Claire Conroy, who suffered from diabetes, a gangrenous leg and an organic brain syndrome, it was argued that “dehydrating to death was ethically permissible because her life had become impossibly burdensome to her”.2

 In the 1984 Crista Nursing Home case3, six nurses were threatened with dismissal because

        they did not comply with a directive to remove nutrition and fluids provided by feeding tubes to two elderly women who were judged to be comatose and terminally ill.  In both cases, the feeding tubes were removed, an act which was in accord with the situation ethics principle that  ‘all decisions asserting “rational control” over death (are) acknowledged and respected, however that be defined’.

        In the 1994 Tracy Latimer case (Saskatchewan), a 12-year-old disabled daughter with cerebral palsy, was gassed by her father, Robert. Many Canadians accepted this as an act of love (mercy killing).  The disrespect and devaluation of human life by society contributed to this act of involuntary euthanasia.

        It has been shown conclusively that the terminally ill do not wish to die or be killed.4  What is surmised here is that helping or aiding terminally ill patients to die takes advantage of them and exploits their vulnerabilities: be they dependency, helplessness and/or despair.  The philosophy of Situation Ethics promotes deliberate killing through denial of food and fluids, by denial of beneficial medical treatments and care and by calculated benign neglect.  It has resulted in a permissive society in which contraception, abortion, infanticide, suicide, assisted suicide and euthanasia have been or are in the process of being socially and legally endorsed.

        Some of the basic principles for protecting the medically and physically disabled, proposed as model guidelines by Fr. Robert Barry, O.P., for supportive care, include the following:

    1.  The life of the person with a mental or physical disability has the same intrinsic value as that of a person considered to be normal or able-bodied.

    2. The primary aim of caregivers is to promote and support the finest physical, mental, spiritual, emotional and social life possible for the medically vulnerable person.

    3. Denial of beneficial, life-sustaining medical treatments and normal care is a violation of the moral rights of the medically vulnerable person.

    4. No medically vulnerable person should be forced to choose between length of life and quality of life. Routine and customary care should be understood as protection from exposure, sanitary care, psychological support, and life-sustaining food and water.

    5. Preserving, extending, enhancing and making more comfortable the life of the medically vulnerable person is always in the best interest of the person, regardless of physical or mental condition.

    6. The legally and clearly competent medically vulnerable person should be encouraged to participate in decision-making to the fullest extent possible.

    7. Decisions about medically vulnerable persons who are severely disabled in any way should be monitored with particularly close attention.

    8. Medical and nursing staff should not assist in the crime of suicide.

    9. Decisions to limit treatment for a medically vulnerable person should be fully documented.

    10. Emergency medical treatment should be given to any medically vulnerable person in the event of injury

or accident.   ¤

Footnotes:

Protecting the Medically Dependent: Social Challenge and Ethical Imperative, 1988, American Life League, Fr. Robert Barry, pp. 112:  1p. 8;  2p. 19; 3p. 19;    4pp. 45-51.