This is NOT About Abortion

Nor is it about euthanasia. It is not about the "right to die." It's about a completely different matter, without the slightest connection to those complex and difficult issues.

This involves a wholly separate set of questions, though they are similarly fraught with nuance.

What do you know about Andrea Clarke? Nothing, right?

You knew all about Terry Schiavo, and you knew her story was just one more example of the insane and dangerous theocratic plans of the religious right. You felt the pain of her anguished husband, as he strove to do the right thing.

But you've never heard of Andrea Clarke.

The bioethics committee at St. Luke's Hospital in Houston, Texas has decreed that Andrea Clarke should die. Indeed, after a closed-door hearing, it ordered all further medical efforts to sustain her life while at St. Luke's to cease. As a consequence, Clarke's life support, required because of a heart condition and bleeding on the brain, is to be removed unilaterally even though she is not unconscious and her family wants treatment to continue.

Andrea Clarke may become an early victim of one of the biggest agendas in bioethics: Futile-care theory, a.k.a., medical futility. The idea behind futile-care theory goes something like this: In order to honor personal autonomy, if a patient refuses life-sustaining treatment, that wish is sacrosanct. But if a patient signed an advance medical directive instructing care to continue — indeed, even if the patient can communicate that he or she wants life-sustaining treatment — it can be withheld anyway if the doctors and/or the ethics committee believes that the quality of the patient's life renders it not worth living.

Contrary to how it sounds, medical futility is not a matter of refusing treatment that will not provide the medical benefit the patient seeks. Refusals of requests for such "physiologically futile care" would be proper and professional. For example, if a patient demanded that a doctor provide chemotherapy for an ulcer, the doctor should refuse, since chemo will do nothing to treat the ulcer.

But Clarke's case involves value judgments rather than medical determinations. In such "qualitative futility" cases, treatment is stopped in spite of a patient's or family's objections — the intervention is necessary not because the treatment doesn't work, but because it does. In essence then, it is the patient's life that is deemed futile and, hence, not worthy of being preserved.

Comments? Questions?

Tsk, tsk. Your reaction is so Twentieth Century. How unsophisticated of you. How ignorant you must be.

Read more HERE. Want to learn more? Don't bother with newspapers or magazines, but a Google search of your own might help.