The Council of Europe has passed a resolution promoting advanced directives in the EU. Fine and dandy–depending on details, of course. But the media has been abuzz about one paragraph. From “Protecting Human Rights and Dignity by Taking Into Account Previously Expressed Wishes of Patients:”
This resolution is not intended to deal with the issues of euthanasia or assisted suicide. Euthanasia, in the sense of the intentional killing by act or omission of a dependent human being for his or her alleged benefit, must always be prohibited. This resolution thus limits itself to the question of advance directives, living wills and continuing powers of attorney.
Some are claiming this as a victory against voluntary euthanasia. Perhaps. But, I like this part the most because it explicitly instructs that a dependent patient’s care is not to be determined by general community values–often anti elderly and disabled–and how, in cases of doubt, advance directives are to be interpreted:
7.8. surrogate decisions that rely on general value judgements present in society should not be admissible and, in case of doubt, the decision must always be pro-life and the prolongation of life.
Right on! If in doubt, life should be the choice. Good push back against a culture that increasingly views withdrawal of treatment leading to death as the default decision when patients are very ill, disabled, or debilitated.
January 30th, 2012 | 8:44 pm
No matter what governments may say about the sanctity and value of life over death, if it is fiscally futile for hospitals to keep elderly patients alive, they won’t do it, will they?
Here in the United States, and after the introduction by CMS of “Value Based Purchasing of Hospital Care” several years ago, public policy (outside the view of the Medicare patients) began to develop in response to the fact that US hospitals are often NOT reimbursed for ICU and CCU time for elderly patients.
This, of course, provides the incentive for hospitals to put influenced and unilateral, unauthorized DNR/DNI code status in the hospital charts of elderly Medicare/Medicaid patients in order not to be financially penalized by CMS.
Why do you NOW never comment on the financial incentives to euthanize the elderly and the disabled when you comment on assisted suicide and euthanasia. You did talk about this years ago.
I’m sure that you recognize that the hospitals quest for “NO CPR” that enables DNR/DNI status in the hospital charts of the elderly – that was made possible by the 1991 PSDA – is often a form of “hospital assisted suicide.”
I’m sure you know that the covert DNRs are possible because there is NO enforcement of the prohibition of discrimination against patients who have not provided the hospitals with advanced directives to waive life-extending and life-saving treatment.
Certainly, our “liberty” and “due process” rights under the Constitution that preserve the right of “informed choice” should be honored.
But! You, as an attorney, never touch on this subject matter. Why?