“Futile care” is a pronounced threat to patient autonomy and the equality of all human life. This is the idea. When doctors think that the quality of a patient’s life is not worth living — but the patient, family, or surrogate want care to continue — doctors can overrule patients and terminate wanted life-sustaining treatment.
Texas is the epicenter of what I call “futile-care theory.” But it isn’t the only locale in which the bioethical policy threatens the lives of patients and autonomy of proper medical decision makers. A Minnesota hospital recently tried to remove a Covid patient named Scott Quiner from a ventilator over the objections of his wife — who is also Scott’s duly appointed agent.
The case ended in court. From the New York Times story:
Mr. Quiner, 55, who was unvaccinated, was hospitalized the next month, and his case became so severe that he had to be placed on a ventilator, according to court records. For weeks, he remained on the ventilator at Mercy Hospital in Coon Rapids, Minn., a city of 62,000 people about 16 miles north of Minneapolis.
Then, on Jan. 11, hospital officials told Mr. Quiner’s wife, Anne, that they would be removing him from the ventilator in two days, over her objections.
What followed was a legal case that raised questions over who has the right to make wrenching life-or-death decisions when patients cannot speak for themselves. It also underscored the tensions between people who refuse the coronavirus vaccine and the hospitals that have been filled with patients sick with the virus, a majority of them unvaccinated.
There is no proof that Quiner’s unvaccinated status led to the attempt to push him off of care. But if so, it was an egregious breach of medical ethics. Patients should be treated for their conditions, not punished by doctors for inadvisable life decisions they make.
Judge Jennifer Stanfield, of the Tenth Judicial District Court in Anoka County, granted the order. On Jan. 15, Mr. Quiner was flown to a hospital in Texas, where, Ms. Holsten said, his condition has improved significantly. She declined to identify the hospital.
Ms. Holsten said: “He was cognizant until they administered a ton of sedatives. That was when he was put on the ventilator.” In Texas, she said on Wednesday, “the doctor said he was moving his hand” and “nodding and blinking his eyes in response.”
Mr. Quiner, who remains on a ventilator, had lost 30 pounds and was described as the “most malnourished patient” a doctor at the Texas hospital had ever seen, Ms. Holsten said.
This part of the story illustrates the core injustice of futile care:
Specialists were consulted and the treatment was “in compliance with Mercy’s policies and procedures regarding medically nonbeneficial interventions,” the lawyers wrote.
At the heart of futile-care theory is the noxious notion that remaining alive can be “non beneficial” even when the patient/family want life to continue. But that is a value judgment, not a medical determination. As such, it should not be up to doctors or bioethicists, but the patient/family.
Futile care is a form of ad hoc and authoritarian health-care rationing. As such, it should not be allowed. The judge made the right call.