Slate: Do the Poor Deserve Life Support?
Slate's article starts with this:Tirhas Habtegiris, a 27-year-old terminal cancer patient at Baylor Regional Medical Center in Plano, Texas, was removed from her ventilator last month because she couldn't pay her medical bills. The hospital gave Ms. Habtegiris' family 10 days' notice, and then, with the bills still unpaid, withdrew her life support on the 11th day. It took Ms. Habtegiris about 15 minutes to die.At first glance, withdrawing life support sounds like a horrible, mercenary thing to have done. But read the article. The author says:Bloggers, most prominently "YucatanMan" at Daily Kos, are appalled because "economic considerations," as opposed to what the bloggers call "compassion," drove the decision to unplug Ms. Habtegiris. ..
The back of my envelope says that a lifetime's worth of ventilator insurance costs somewhere around $75. I'm going to hazard a guess that if, on her 21st birthday, you'd asked Tirhas Habtegiris to select her own $75 present, she wouldn't have asked for ventilator insurance. She might have picked $75 worth of groceries; she might have picked a new pair of shoes; she might have picked a few CDs, but not ventilator insurance.Which would you take, if offered? $75 in cash, or a lifetime ventilator insurance policy? Is it Baylor Regional Medical Center's responsibility to keep someone alive potentially for years at a significant cost and no reimbursement?
Tough questions. No easy answers.
posted by Paul Wilczynski @ 12:37 PM
3 Comments:
I'd be real careful with this story Paul. It's all over the lefty blogs and Baylor almost certainly in no position to respond because it's going to courts for sure.
Law and medical ethics pretty clear in these cases, at least in Illinois. When they become problems it's cases like Schiavo were there is a dispute on who can make the decision to refuse care i.e. pull the plug.
Usually the problem is not the economics. Once your receiving care, the system is loath to stop for fear of the suits.
We had a similar story here in Chicago. A man with horribly disfigured face would beg in the subway in the loop. He carried a sign saying Loyola University Medical center was refusing him plastic surgery because he couldn't afford it. I saw this guy one day and it was shock to turn the corner and suddenly see him.
Loyola was on the news telling everyone they would do the surgery for free but the guy kept refusing treatment.
One obstacle to being a big public institution like Baylor is you have an army of lawyers who adivise you to say nothing. I'd wait and get Baylor's side of this story. It's an outstanding institution run by compassionate staff and administrators. I would not be so quick to judge them here.
I'm not a lefty. I'm a righty.
I'll tell you right now that this was wrong. Texas Futile Care Laws provide for only 10 days for a patient to find alternate placement when a health provider gives them such a notice. That's not sufficient time.
The only reason we have ten days is because Right to Life people fought like heck to get those days back in 1999. That was the best they could do.
The people on the other side were purportedly about "patient autonomy", in other word, "the right to die folks".
Unfortunately they went from that to a situation where "patient autonomy" can be trumped if a physician decides that further treatment is futile or "medically inappropriate." Their ethical position is that some life does not have the level of quality requisite for it to continue.
Many physicians, these days, take a very mechanistic view of human life these days. (I represent health providers)
Pulling the ventilator on the 11th day tells me that this was about money, not about pain or quality of life. The reason I say that is because she wanted to wait to see her mother.
To me, medical ethics would dictate that care be continued until she could say her goodbys to her mother if the physicians were truly concerned about futility of care and medical inappropriatness (which is usually about intractable pain or quality of life) as opposed to the hospital bill. I serve on a hospice ethics committee and I would have fought to continue treatment, at least until she could say goodby to her mother.
The lefties are just using this to smear Bush and to argue for national health care. Bush was the only reason that we have even ten days because he allowed the Right to Life people an active role in the Coalition.
The lefties don't understand that most of the people who supported Futile Care Law in Texas were left of center. Most of the people who think that some life is not worthy of continuing are left of center.
This situation is distinguishable from the circumstances cited by your commenter above. We are talking about a conscious woman, removed from a ventilator, dying while knowing that she is suffocating to death--after being allowed only ten days to find alternatives.
By the way, this probably will not go to court. Physicians and hospitals are given immunity for actions taken under the statute in question as long as they act "reasonably". Given the way the statute is written--a lawsuit against them would probably be very difficult and not one that a plaintiff's lawyer would take on.
Sue Bob,
Can you cite sources that shed light on the history of the debate over the law? I've been unable to come up with any via Google so far.
Thanks,
Jeff Cagle
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