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Ethicist says keeping people alive wastes money

By on Thursday, 19 July 2012

Hydrating and feeding dementia patients is a waste of the National Health Service’s resources, a leading medical ethicist has said.

In an article for the British Medical Journal, the chairman of the Institute of Medical Ethics criticised a High Court judgment in September last year, which concluded that it would not be in the best interests of a brain-damaged woman to withdraw her artificial hydration and nutrition.

Writing under the heading “Sanctity of life has gone too far”, Professor Raanan Gillon, who is also an emeritus professor at Imperial College London, said: “The logical implications of this judgment threaten to skew the delivery of severely resource-limited healthcare services towards providing non-beneficial or minimally beneficial life-prolonging treatments including artificial nutrition and hydration to thousands of severely demented patients whose families and friends believe they would not have wanted such treatment.

“The opportunity cost will probably be reduced provision of indisputably beneficial treatments to people who do want them.”

In September last year Lord Justice Baker refused to end the life of a minimally conscious woman by permitting the withdrawal of her food and water.

The woman, known as M, was in a minimally conscious state following a brain injury in 2003. Her mother and sister argued that she would not want to be kept alive in such circumstances and appealed to the High Court for the withdrawal of M’s artificial hydration and nutrition. She was not receiving any other life-sustaining treatment other than food and water.

Mr Justice Baker rejected their request, saying: “The factor which does carry substantial weight, in my judgment, is the preservation of life. Although not an absolute rule, the law regards the preservation of life as a fundamental principle.”

But Professor Raanan Gillon argued that the judgment defied common sense and the Hippocratic oath. He wrote: “Since Hippocratic times (at least) the primary goal of medicine has been to benefit people’s health. Until recently, the exercise of doctors’ very limited capacities to prolong life has almost always led to such benefits. Now, however, medical advances have led to a vastly increased capacity to keep people alive without, in many cases, providing any real benefit to their health.

“This recent judgment, and the practice directions of the Court of Protection, logically imply that doctors should no longer decide, in consultation with those who know their incapacitated patients, whether life- prolonging treatment including artificial nutrition and hydration will be in their patients’ best interests.”

Professor Gillon concluded: “Unless this judgment is overturned or modified by a higher court it will gradually and detrimentally distort healthcare provision, healthcare values and common sense.”

At the time of the appeal Caroline Harry Thomas QC, the Official Solicitor appointed to represent M, said: “In M’s case, a person is in a minimally conscious state and is otherwise clinically stable. It cannot, as a matter of law, be in that person’s best interest to withhold or withdraw life-sustaining treatment, including artificial nutrition and hydration.” She said that as such treatment was withdrawn from M, it would amount to the “actus reus [guilty act] of murder”.

Meanwhile, a man suffering from locked-in syndrome recently won a High Court battle to proceed with his request to allow doctors to end his life. A High Court judge ruled in March that Tony Nicklinson’s case could proceed to judicial review.

  • Boanerges

    “Now, however, medical advances have led to a vastly increased capacity to keep people alive without, in many cases, providing any real benefit to their health.”
     
    As if being alive is bad for your health! Where do they find these people?

  • SJG

    These were my thoughts exactly.

  • Sigfridii

    It is my understanding that doctors ceased to take the Hippocratic oath many years ago. Some, such as this nincompoop, have always considered themselves above such things, and even above the law of God.

  • Parasum

    “Ethicist says keeping people alive wastes money”

    ## Would he prefer to have all the unemployed put up against a wall ? And the sick too ? “Liquidating undesirable elements” – not people, elements (!) – would save a large fortune. Then “parasites” like him could be “disposed of”…

    World-wide extinction of man would save even more.

  • Euthebass

    I can only speak for the teaching that Christ does through my mother, who has had dementia for many years.  The value and beauty of God speak loud in her

  • Nat_ons

    Preserving life and imposing it / terminating it are not the same thing, ever; this is an important – if rarely addressed – moral distinction that must separate a spiritual preparation for death and the scientific prolongation of existence. That is, the ends or purpose of the act – not the material means alone – determine the moral status of the act; sadly, final purpose is no longer seen as a fitting measure in judging right or wrong for the use of material means. Artificial feeding/ respiration/ cardiopulmonary activity when introduced for the purpose of preserving a life that it may be restored to health cannot be measured with the same moral judgement as prolonging existence alone, irrespective of any ultimate end (other than prolonging material existence). 

    To the orthodox Christian tradition of moral reasoning, the purpose of preserving life in to restore (some degree of) health (however fleeting or ultimately transient) differs in the end at which it aims to that of prolonging one’s existence merely because our life can be prolonged; in this understanding of moral reason then, the continuing or withdrawing artificial means of life support must rest its basis for action (and thus is legitimate expression) on the purpose not the mechanics (or cost or value or sentiment involved) of the act.Killing a man by starving him to death, no less than poisoning him or suffocating or allowing him to drown etc, because he is physically or intellectually incapacitated is an immoral act in this tradition of moral reasoning – even if the one being killed wants to be killed or that it may be deemed inconvenient to keep him alive. For if he his killed accidentally – in error or as a consequence of other treatment – it might be considered wisely as manslaughter (whether culpable or not), because the end envisaged by the agent of death was not his death. To kill him with the purpose of killing him with just cause – say, because his life is too expensive to sustain, or he insists wants to be killed, or it seemed good (at the time) – would classically be deemed to be murder: the end envisaged by the act was his death, that was the purpose of the act and the moral agent doing it, and there is always malice in pursing such an end (even if it were well intended).It is only the notion of ‘just cause’, in my lay (and therefore limited) opinion, that is left open to argument in terms of moral reason (if not in regard to vagaries of human legislation). After all, it is merely a just cause the differentiates capital punishment from other forms of killing as a moral act; proportionate self-defence is one such reasonably argued ultimate just cause, and that principle goes for the State facing otherwise uncontrollable assault (not the simple convenience of not having to pay for the keep and rehabilitation of man-slaying convicts, or some ulterior desire to deter or inflict retribution). What cause might be considered ‘just’ to moral reason in allowing a soul to have a spiritually prepared death – freed from intrusion by medically pronged existence – rests with that same basis of moral reasoning which considers the provision of adequate medial comfort that may also incidentally hasten death in the dying; the real difficulty faced by doctors, courts and moral agents of all kinds today (again only in my opinion) is in the infantile fast-forward-button culture that prevails among us .. the individual insists that it is his choice to press the fast-forward-button as he will or to require another to press it for him if he wills it and thus that others should insist that he would want the termination of his life fast-forwarded if he could press that button: and none of this fast-forward-button ideology in ethical. legal or material life has the least regard for moral reasoning (with all its careful understanding of justice, charity or purpose).

  • Rogelioinge

    Son of thunder … I love the name! Could not agree more with you. An ethics professor without morality is an oxymoron and seems to be the case here. He has to obscure the simplicity of the situation by calling simple food and water artificial nutrition and hydration. Three cheers for the good judge!

  • Roy

    Such extinction is what some of these so called experts would prefer

  • Dmikem

    Professor Gillon states that is a waste of resources to hydrate and feed dementia patients.  I think it a waste of my resouces (time) to read the drippings of this immoral professor.  Didn’t we fight a war in Europe to end atrocities done to the helpless in concentration camps.  It doesn’t matter if a person is being killing in a clinical setting or in the filth of a concentration camp the end result is the same.  People like this ethisist are dangerous; who is next, the mentally challenged, people with incurable diseases and criminals?  How about obese people, they suck up medical resources due to their weight when they come down with diabetes, high blood pressure etc.  Should we stop feeding the elderly? Although they can play bridge, watch TV, visit with staff and family, pray etc. they have no future.  How about the blind and people or people with birth defects, anybody in a wheelchair…..How about ethisists who believe extermination is a solution to the medical cost situation, should we continue feeding them?

  • James

    Correct, the modern medical code of ethics is but a poor relation to the Hippocratic oath.  This ignorant “ethicist” has no idea what the Hippocratic oath is and is claiming support euthanasia from the Hippocratic oath, the very antithesis of what the oath prescribes (to do all to protect life)…These people have sold their soul to Satan.

  • formerly_Henrick_Maundey__-666

    The thing is it’s appalling for some idiot science academic to judge even on supposedly ‘brain dead’ because life is sacred and if a person can be kept alive you do it because so many miracles have happened where the even those with no life signs in their minds have come back. How dare he judge senility and old age problems to be a waste as these people fell and respond to love and have sight and hearing and music affects them. No way ever the scientists in charge because we will have a Nazi type state given to us as utopia.

  • formerly_Henrick_Maundey-__666

     The thing is it’s appalling for some idiot science academic to judge
    even on supposedly ‘brain dead’ because life is sacred and if a person
    can be kept alive you do it because so many miracles have happened where
    the even those with no life signs in their minds have come back. How
    dare he judge senility and old age problems to be a waste as these
    people feel and respond to love and have sight and hearing and music
    affects them. No way ever the scientists in charge because we will have a
    Nazi type state given to us as utopia.

  • Stephen McCormack

     A few points to consider:
    1) Delivery of nutrients through an tube inserted into the veins/through the abdominal and stomach wall is not  ‘simple food and water’, but a medical treatment which is invasive and often painful
    2) All doctors in the UK follow the principles laid out by the General Medical Council including: ”The benefits of a treatment that may prolong life, improve a patient’s
    condition or manage their symptoms must be weighed against the burdens
    and risks for that patient”
    3) Boanerges – longevity does not equal health.

  • Nice athiest

     You shouldn’t be referring to the Law of God as there is no such thing, additionally, life requires conciousness and that exists in microbes who are aware of their surrounding and hence, prey on other microbes… but this person in this article is not aware of their conciousness and thus, technically as proved in science, she is not naturally alive.

    The ethicist is thus right in his opinion.

    End of discussion.

  • Nice Athiest

    Nobody should be referring to the Law of God as there is no proof yet of the existence or non-existence of God,
    additionally, life requires conciousness and that exists even in microbes who
    are aware of their surrounding and hence, prey on other microbes… but
    this person who was unfortunately injured in this article is not aware of her conciousness and never again will be and
    thus, technically as proved in science, she is not naturally alive. The ethicist is thus right in his opinion.

    End of discussion.

     

  • Monty_1957

     god does not exist