Wednesday, June 23, 2010

Idaho imposes rationed care on its citizens.

On July 1, Idaho health care workers will gain the right to refuse end-of-life care that the worker considers objectionable. People with disabilities and the frail elderly need to be concerned.

There are huge ethical problems with futile care treatment decisions especially considering how modern bio-ethics are defining futile care treatment decisions.

David Irwin, spokerperson for the AARP stated to the media:
"Our members contacted their legislators by the thousands, and they moved forward with it anyway," Irwin said. "For our members to have their issue fall upon deaf ears was extremely problematic."

Heading into election season, Irwin said Idaho AARP has surveyed its 180,000 members (90 percent of whom vote regularly) to see which issues matter most to them.

Repealing the health care conscience bill is near the top of the list.

The only issue more important to Idaho AARP members is resolving Idaho's state budget problems."
I believe that health care workers should have the right to conscientious objection, but the new law in Idaho will create an inequality of care that will result in people with disabilities or other vulnerable people dying from a lack of care based on the discriminatory attitudes of individual health care workers.

Many people believe that the way to control the rising cost of health care, and the way to stop the practise of providing extra-ordinary, excessive and burdensome medical treatment is to ration it, whether the patient desires to receive it or not.

Governor Otter
Idaho Governor Butch Otter expressed reservations about the bill to Senator Brad Little. He stated:
"Forcing health care professionals to provide services they find morally objectionable is unacceptable; however, negatively impacting patients' rights - especially when it comes to end-of-life decisions - is equally problematic," Otter wrote. "I encourage the Legislature to revisit these issues and the definition of heath care service to ensure patients receive the care they may need with dignity and respect, and without imposing on the morals of a provider."
I agree with the Governor Otter, but I wonder why he didn't send the bill back for revision before signing it into law?

I believe that to always provide futile, extra-ordinary treatment or to withhold treatment based solely on the whether or not the medical care giver considers it objectionable represent two extremes. The ethical answer lies somewhere between both extremes.

I would suggest that medical treatment should be provided to someone unless the benefit of the treatment is minimal or the burden of providing the treatment is excessive. Further to that, any case, such as the Golubchuk case from Winnipeg, whereby the family has religious objections to withholding or withdrawing a particular medical treatment, that their religious freedom should be respected.

Terri Schiavo
Also, hydration and nutrition should never be considered to be medical treatment, but rather normal care. Therefore people should never have fluids withheld or withdrawn with the intention of causing that persons death by dehydration.

We have a lot to learn from our medical ethics heritage. The Hippocratic Oath stated: "Do No Harm". So long as we uphold the Hippocratic Oath we will be able to respect the needs of all patients while respecting the limits of medical treatment.

Link to the article in the CDA Press in Idaho: http://cdapress.com/news/local_news/article_443903c6-b7a4-5faf-929d-b66271b7115d.html

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