When resources are scarce, who gets to decide who lives and who dies? Who gets to decide when and to whom care will be delivered? And who decides what sort of care they can get?
The debate is not new, but now again begs attention ("When death is coming, difficult choices are required," Jan. 20).
The recent events involving the case of Scott Quiner have reignited the debate. In our own backyard, Mercy Hospital in Coon Rapids, a man was about to have his lifesaving machines unplugged against his will. The hospital even went to court to demand that his care be terminated. Its powerful lawyers declared, "Plaintiff's position is not supported by medical science or Minnesota law, and as a result, Mercy will ask the Court to issue an order that Mercy has the authority to discontinue Quiner's ventilator and proceed with his medical care plan."
In this case, the "medical care plan" was to discontinue care, which would have caused him to die. (Quiner was transferred to a Texas hospital, where he has since died.)
But what has happened to erring on the side of life? In baseball, the tie goes to the runner. Not so much if you are Quiner, under the guise of "medical science."
This is not just a Coon Rapids problem or a Minnesota problem. It is national. This situation is being repeated, with or without court drama, in countless places across the country. This makes the problem even more compelling to address now.
When resources are strained, who decides? When "quality of life" is declining, who decides that it is time for a person to die? When disabling conditions hamper a "good life," who makes the call?
The Germans in the early 1940s made it simple. They created Hadamar Centre in the town of Hadamar, Germany, where they sent the infirm, the mentally ill and people with disabilities. The medical personnel and staff at Hadamar killed almost all of these people by lethal drug overdoses and deliberate neglect, according to the Hadamar Holocaust Encyclopedia.
We all believe we are better than this, but when we pull a person's plug to free up bed space for someone else more worthy, we had better have the debate.
Who decides who is incurable? Who decides who is beyond hope?
These judgments are based on "medical science." Who decides that? Modern medicine has come a long way since bloodletting, but all admit it has a lot to learn.
In the past, innovation has often been met with skepticism. Case in point, Dr. Ignaz Semmelweis, a German obstetrician in the 1880s, discovered that if his doctors washed their hands none of their delivering mothers died. This was in stark contrast with the 10% mortality rate elsewhere. Dr. Semmelweis, who became the father of hand hygiene, was largely misunderstood. During his lifetime, he was primarily known as an aggressive and eccentric man who maliciously attacked doctors based on unsound claims. After his death, it became clear that his theories about hygiene had validity. Yet, Semmelweis spent his life on a one-man crusade for which he was mocked, ridiculed and eventually committed.
Remarkably, despite the medical opposition at the time, infection control has been one of the greatest medical breakthroughs in the past 130 years. Yet it was not embraced at the time of discovery. How many other worthy and lifesaving treatments have been quashed by professional pride, financial greed or apathy? How many other innovative doctors have been chastised and harassed for trying something new that has the potential to save lives? Shouldn't all people and their doctor have the "right to try" a new potential remedy for any number of diseases? What would "medical science" look like then with the discoveries that would be made?
It is time for the debate.
The "right to live" should be a fundamental right for all persons, not just the worthy. The "right to try" should be available for all, not just those well-connected or well-heeled.
Bring on the debate. It truly is a matter of life and death.
Jim Abeler, R-Anoka, and John Hoffman, DFL-Champlin, are members of the Minnesota Senate.
