The counterpoint by state Sens. Jim Abeler and John Hoffman ("Bring on the 'right to live' debate," Jan. 25) to the commentary by Drs. John Hick, Michele LeClaire and Heidi Erickson ("When death is coming, difficult choices are required," Jan. 20) completely missed the point of the original article and is embarrassing in its lack of understanding of the issues as well as in their proposed alternative. As a call for public debate, it sets the bar extremely low regarding the quality of any such debate. As the doctors made clear in their carefully reasoned and well-written article, the difficult choices that arise in medical care due to limited resources are not about evaluating the worthiness of any individual to live but about the complex process of medical decisionmaking as it relates to both individual patients and the use of societal resources.
As they discuss, these decisions are by nature societal. They do not call for the right of individual physicians to arrogantly decide who is worthy to live but for work on a national consensus. Abeler and Hoffman use an example from the 1880s that is wildly irrelevant to current medical practice to suggest that such decisions are currently directed by the pride, greed and apathy of physicians as they go about denying care to individuals they deem unworthy and quashing brilliant innovations. In fact, the profession of medicine is subject to a colossal number of checks and balances, which include scientific and evidence-based practices that are researched and practiced under intense peer review, as well as immense social control via the legal system.
The decision to terminate futile care, in particular, is not taken lightly. It is not made by individuals, but under the purview of ethics committees consisting of physicians, social workers, pastors, lawyers and others who come together to grapple with the complex issues that have to be addressed. Abeler and Hoffman propose that, instead, such decisions should be individual — that each of us should have the "right to try" any medical care we might wish would work and be allowed to mobilize societal resources to do so. This is far from a call for open debate. It is a proposal that completely short-circuits the very idea of communal decisionmaking.
Virginia Dale, Minneapolis
The writer is a physician.
Abeler and Hoffman challenge us to respond to the life/death debate, as it seems there is too much confusion over medical science judgments, human rights priorities and even the innovative right to try. Obviously, not enough effort has been expended to encourage everyone to become educated and complete a medical directive, often to accompany their final will and testament. We need to promote this far and wide with guidelines and sample forms that will specify the detailed action plan should one become incapable of making life/death decisions for themselves. This should be a solid legal document reflecting the rational decisions of the individual. Perhaps these could even reflect different interventions at different ages — more at age 40, less at age 90.
Face it, we are all going to die irrespective of any science-fiction, cryonic attempts to rejuvenate. We were created to live out God's plan for us, and we must respect that plan, a time to live and a time to die. Modern medicine interventions can keep a body alive in some of the worst conditions imaginable. We can all give our doctors and loved ones the solace of a guilt-free legal directive of our intent, moving on to the farewell celebration of life.
Michael Tillemans, Minneapolis
Abeler and Hoffman put the onus on the medical providers for deciding to take a patient with COVID off a ventilator. It is worthwhile discussion. But nowhere did I see the writers put any responsibility on individuals to do what is necessary to protect themselves from death, in this case, by getting fully vaccinated. It is a tragedy that anyone dies unnecessarily, but at least in this case, let's not lay all the blame on the provider.
Karl Samp, Brainerd, Minn.
It took a lot of courage for the authors to write "When death is coming, difficult choices are required." It's a complicated topic and they gave it all due sensitivity and circumspection. But they also wrote with shocking bluntness about the pain suffered by individuals and now the whole health care system. We're long past due having the public discussion that is needed to shape humane, rational policy. End-of-life circumstances are inevitable, so have the conversations that can serve you well and your family and society. As they so clearly pointed out, now the matter is forced urgently upon us.
Bob Worrall, Roseville
Mindful of breakthrough rates
Among the mistruths that people opposed to requiring proof of vaccination to go to restaurants or sporting events propagate is the notion that vaccinated people are just as likely as unvaccinated people to spread COVID-19. Two letters in the Jan. 17 Readers Write section seem to jump to this conclusion, one saying that "I have seen breakthrough infections among my co-workers ... so being vaccinated does not guarantee anything," and another saying, "It is very obvious to anyone paying attention that the vaccine isn't stopping the spread of omicron from vaccinated and unvaccinated people alike."
Well, it is obvious to me that these writers don't understand that the mere fact that breakthrough infections can occur doesn't mean that the likelihood of spread by vaccinated and unvaccinated people is the same. According to the Minnesota Department of Health website, the rate of breakthrough infections among fully vaccinated people in Minnesota is only 4.85%. I'd rather dine in a restaurant in which fewer than 5% of people might be spreading COVID from an as-yet asymptomatic infection than in a restaurant in which the possibility of spread may be much higher.
Bill Kaemmerer, Edina
Just as suppressed as ... we are?
As evidence of voter suppression in the editorial "Voting rights fails, but fight goes on" (Jan. 21), the Star Tribune Editorial Board cites the example of Iowa shortening its polling hours. At the end of the piece the board holds up Minnesota as an example for other states for how elections should be done. The board neglects to say that Iowa changed its polling hours from 7 a.m. to 9 p.m. to now be 7 a.m. to 8 p.m. — the exact same hours as in Minnesota.
Joel Boon, Shakopee
It does not matter if an attack on our democracy was unorganized or perpetrated by a mob that didn't fully comprehend what it was doing. And it does not matter if an attack on voting rights doesn't significantly impact voter turnout, as some have claimed of voter ID laws. If any attacks on democracy or voting rights are not met with outrage, then, even if ineffective in their own right, they will serve to normalize any such attacks and embolden those who would attack with more purpose.
Lies about electoral fraud have led to bigger lies about a stolen election. Attacks on the legitimacy of our institutions have led to a significant number of Americans accepting that political violence is justified. Advocates for voter suppression have grown more brazen with restrictions on mail-in voting, precincts and voting hours, and now even attacks on procedural vote counting. However it may have functioned in the past, the filibuster is now abused to suppress the will of the majority and to perpetuate a growing threat to democracy. I can imagine few causes more worthy of taking the political risk of eliminating the filibuster than standing up for voting rights. If we do not make this stand now, I fear that we may not have a platform to stand on when the next attack comes.
Neal Solmeyer, Edina
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