Patients Deemed “Futile” by Doctors Face Encouraged or Imposed Death

Opinion   |   Bobby Schindler   |   Jun 13, 2016   |   3:48PM   |   Washington, DC

Recently, a New York Times article titled, First Rise in U.S. Death Rate in Years Surprises Experts, reported that the 2015 death rate in the United States rose for the first time in a decade.

Although the research did not attribute the rise to any one reason, in particular, it did state that the rising death rate could signal a decline in the health of the nation. We know that many Americans don’t necessarily lead healthy lifestyles, but there is deeper reason to be concerned.

In my many years advocating through the Terri Schiavo Life & Hope Network, I’ve come face-to-face with the reality that our medical system often prioritizes their profit over their patients.

While it’s true that hospitals, the chief organs of our medical system, are necessary institutions and save untold lives, they are also the number one cause of unintentional deaths in adults—resulting in something close to 800,000 deaths annually. This means hospitals are the leading cause of death for American adults. Not heart disease. Not cancer.

Even more disturbing are the medically vulnerable patients who are targeted for encouraged—and sometimes, tragically, imposed—death when their situations are deemed “futile.” No records are kept to convey precisely how many medically vulnerable patients are encouraged to die or who face denial of care through withdrawn treatment, but we do know that it has become relatively easy for medical professionals to withhold lifesaving or life sustaining treatment.

Currently, 46 states recognize a provider’s right to refuse life-saving or sustaining medical treatments. New Mexico, for example, allows hospitals to deny care if “the treatment would not offer the patient any significant benefit, as determined by the physician.” In Maryland, the attending physician may withhold or withdrawal medically ineffective treatment if the physician and a second physician certify that the treatment is ineffective.

What constitutes “life sustaining” or “ineffective treatment,” though? In the popular imagination, these terms likely conjure images of defibrillators, resuscitation scenarios or ventilator machines that help a patient breathe. Unbelievably, though, access to food and water is now considered “medical treatment” for hundreds of thousands of patients across the country, and is the sort of “medical care” that would be denied in a state like New Mexico, “as determined by the physician.” That is correct, food and water.

There are more than 5.7 million patients who are admitted annually to American intensive care units. Roughly 11% of those patients end up labeled “futile,” equating to some 627,000 patients facing “end of life” decisions not necessarily because they are dying, but because their medical provider believes their hastened death is the best “health care” they can hope to receive.

In an interview with senior author of the study, Dr. Neil Wenger, a UCLA professor of primary care medicine, provided some insight as to the conflicts that arise from deeming a case “futile.” He was asked, “If a patient gets admitted to an ICU with the hope he/she might benefit, and then deteriorates to the point of futility, how do you discontinue care?” His response? “If there is no resolution, then we have a policy where you can override a family.”

Included in this erosion to make our own medical treatment decisions, is the increasing controversial brain death diagnosis, and how it ties directly into the organ donation program.

It has become apparent that brain death diagnoses are being made so quickly that in many cases, the patient is given no opportunity to prove the doctors wrong. Often times the diagnosis is made within hours of their loved one being admitted to the hospital. All in what seems to be an effort to harvest the patient’s organs. If families object, and want to try different treatment options, the hospital will either override the family, or will place enormous pressure on them to rapidly accept the hospital’s decision.

Unbeknownst to the family, once this decision is made to take their loved one’s organs, the patient/donor must be breathing, their heart must be beating, and they will also have a circulatory system. The patient/donor is actually killed during the process of dissection for the sole purpose of organ transplantation.

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Dr. Wenger’s chilling response that he can “override a family” underscores the notion that, advance directives offer meaningful protection, is no longer true. In other words, even if you specifically ask for certain treatment in your advance directive thinking you’ll receive that treatment in a moment of medical crisis or incapacitation, a physician can choose to disregard that directive.

According to a report published by The Robert Powell Center for Medical Ethics, “The laws of all but eleven states may allow doctors and hospitals to disregard advance directives even when the directive calls for treatment, even food, or fluids.”

Increasingly, health care providers who consider a patient’s “quality of life” too low are denying life-preserving measures. Incredibly, this can also include denying care against the expressed wishes of patients and families. Moreover, the laws of most states provide no effective protection against this denial of care.

The result is that in most states, if you want life-saving treatment—like food and water—there is no guarantee your wishes will be honored, even if you make them clear in a valid advance directive. When challenged by families, medical providers often claim the treatment is being denied because it is (here’s that word again) “futile.”

The current condition of our medical system didn’t happen overnight. It’s true that the Affordable Care Act, in a relatively short period of time, has increased our vulnerability in many senses. Yet many of these changes have been occurring for years, and the dynamics involved can’t be explained easily. The simple truth is that our medical system has fundamentally changed, and that change affects every single American.

What’s the simplest way to avoid becoming the latest victim of our profit-driven medical system?

Don’t get sick.