“A Life Versus Death Struggle:” If the Medical Profession Calculates the Value of Life on an Economical Basis, Who Calculates the Value of Death?
By Trudy A. Martinez
Once upon a time in America, an individual was guaranteed the right to “life, liberty, and the pursuit of happiness”. Then death was a natural process. The meaning of “life, liberty, and the pursuit of happiness” changes with the growth of the Medical industry. Life itself becomes a pursuit of the medical profession, leaving the value of death obscure as medicine views death as a failure and the right to die hinders medicines’ quest for technological immorality.
Because death is a failure to the medical profession, the prolonging of life by artificial means rejects bereavement, leaving death with no place in life. When Mary Catherine Bateson examines, “What is needed to give death its proper place in life?” She says, “In rejecting death, [society sets itself] against nature”(8). “Having interfered with the process . . . [society] should accept the fact that the cast and glory of technical progress is to require choice: . . . choice of how to die”(8).
In other words, Bateson advocates the “right to die”. In 1971, the Supreme Court rules “there is no constitutional right to choose to die” (Kearl 412). Nevertheless, death does not necessitate constitutional approval. Death is a natural process.
On the other hand, death revolts physicians since natural death hinders medicine’s quest for technological immortality (Guillemin 32). Therefore, “dying . . . is not something the individual patient . . . really does, [dying] is a matter of . . . withdrawing life supports” (Guillemin 32). Many doctors feel to choose to die over maintaining life on life support is committing suicide. In ancient time, “because life was so trivialized, Romans and Greeks raised few moral objections to suicide, and they usually only protested suicide when it caused economic or social loss”(Barry 25).
Life in America, on the other hand, is not trivialized; instead, life is immortalized, causing death to lose its right. As a result, in an immortal society for an individual to re-claim the natural right of death, he resorts to what the medical institutions now define as suicide, unplugging the machines. Such a death does not constitute a social loss when the individual’s quality of life is gone. To retain life that has loss quality causes an unnecessary economical drain on the family and the patient, while at the time, it has the opposite effect on medical professionals; they benefit economically. Although a medical professional may believe he has the patient’s best interest at heart, not always does he serve the patient’s best interest. This is especially true when considering the spiraling cost of maintaining life supports in the equation.
“If antiquity privatized suicide and objected only when there was economic or social loss, Medieval Christianity saw a deeper meaning and value in life”(Barry 26). However, in current times, death to a Christian has more value than life as the medical institutions defines life. For a Christian death brings life forever after. Yet, life, in the sense of forever, is in heaven, not on earth. To some dying individuals, whether Christian or not, death has worth; it ends suffering and pain. To the Medical industry, life has worth; it increases profits, while at the same time, decreases a sense of failure. Consequently, a safeguard to the health-care profession’s own perception of adequacy requires the devaluation of death.
When death is devalued, the voice of the people rings out: “Whose death is it, anyway?” (Seligmann 69). Once, death came naturally. Then, a decision to die was not necessary. However, technology changes all that. For example, the question asked about Carrie Coons, 86, was “Does she want to die?” Such a question is unfair. Nobody wants to die if his or her life has a promise of quality. However, Mrs. Coons lost through deprivation a quality of life. She was “kept alive by a feeding tube,” a state “her doctor called a ‘persistent vegetative state'”(69). “Dr. Michael Wolff . . . called her chances of recovery ‘nil'”(69). Even though she was in a vegetative state with no hope of recovery, Mrs. Coon’s sister had to seek and receive a court order “to have the feeding tube removed”(69). With total disregard for the family wishes and with the knowledge that her chances of recovery were non-existent, the doctor requests a hearing that blocks the order “to remove the feeding tube”. Why? Because doctors believe in order for death to be natural, it requires a decision. When the doctor asks Mrs. Coons “whether she wanted her feeding tube removed”, she answers, “according to Wolff, it would be a difficult decision”(69). Wolff assumes her answer implies she wants to live regardless of her quality of life. Yet, is this really the case? Her sister says, “From the look in her eyes . . . she [is] trying to tell me, ‘Let me go'” (69). She lingers now “in limbo until she either speaks clearly or dies”(69). In other words, her sentence is a life of suffering, not a life of happiness, but one that is literally a “Hell on Earth”.
In the past when our ancestors cried: Give me life, liberty, or death, little did they know that when life is given, liberty is curtailed, and death is denied. “. . .To dispense death is one [decision] in which society as a whole has no interest”(The Economist 60). Today “. . . autonomy decides . . . the ‘right to die’ but it is a principle that . . . leans toward life, not death”(The Economist 60). This is probably so because most people want to live. Nevertheless, some want to end the suffering and pain and die as naturally as possible. They want “To civilize death, to bring it home and make it no longer a source of dread . . . . The road leads . . . to acceptance and understanding” (The Economist 60).
Not all doctors agree abandoning treatment achieves the primary good or that an individual has the capability to decide for himself. For instance, Dr. David C. Stolinsky, M.D. says, lawyers and ethicists persuade us to regard “. . . The cessation of active treatment for the senile or incurably ill and the omission of effective treatment at the patient’s request . . . as definite goods to be eagerly embraced . . . . [Therefore, the] competing good–beneficence–has been largely displaced. . . . [In addition] autonomy has out paced beneficence. . . I believe it is a mistake to make [autonomy] superior to ‘Thou shalt not kill’ . . . . But those who encourage it, even for the best motives, are in fact performing an experiment with all of us as subjects . . . I don’t recall giving my informed consent” (Appelbaum 2).
The trouble with doctors like Stolinsky is they feel they are superior and they should rule over a patient’s right to autonomy.
Stolinsky says, too much autonomy can lead to blaming the patient for his illness, an abdication of responsibility for decision-making, an uncaring attitude toward society’s unfortunates, and (in the extreme) allowing various “undesirable” to die as we stand by (Appelbaun 2).
He says autonomy should not be superior to “Thou shalt not kill”, but in fact, unknowingly, he puts beneficence superior to “Thou shalt not steal.” When technology deprives a patient of death by supporting a life lacking of quality has not a theft occurred? Because of these type of circumstances, patients like L. McAfee are being forced to “petition . . . [courts] for permission to turn off” ventilators or other artificial means that purport to “prolong life”, when in actuality, they are only “prolonging death” (Death Wish 67).
McAfee’s death was prolonged after “. . . a motorcycle accident left him paralyzed from the neck down”, leaving him dependent upon artificial means to maintain a life without quality or hope. McAfee won his right to autonomy, his right to refuse medical treatment. In winning his right to refuse medical treatment, McAfee gains his “death wish” (Death Wish 67). “McAfee’s situation has revived a smoldering controversy over whether health-care providers should help the disabled commit suicide” (Death Wish 67). The question is disconnecting an artificial means that maintains an inadequate quality of life committing suicide? If Stolinsky were to decide, the answer would be yes. However, Stolinsky puts no value on death. On the other hand when you consider all McAfee wants is to allow the removal of artificial means that robs his death from him, the answer to the question should be no. When the value of life is not meaningful, the value of death is priceless. Judge Johnson found McAfee to be a rational adult and that his “death wish” had value. Consequently, he ruled that McAfee had the “right to refuse life-sustaining treatment. . . .” The Judge said, “The ventilator to which he is attached is not prolonging his life; it is prolonging his death”(Death Wish 67).
Life is “The heartache that has no end” in the case of Kim Goetchius. She suffers from a severe head injury received after she fell from a “careening golf cart”. Since then, she has been in a persistent vegetative state for a period of eight years. Hope for her recovery is non-existent. Nevertheless, artificial means keeps her alive, hoping for a miracle. She is not alone; 10 percent of the patients at the St. John Dealon Hospital share the same status. The spiraling cost annually per patient suggests profits of the institution plays a role in the decision to maintain life supports. Why else would Kim’s grave condition leave her doctor, Timothy Keay, agonizing “over the unanswerable question:” Are we “. . . protecting life or making a mockery of it?” (Buckley 54).
Not only is death prolonged but death also comes prematurely through unnecessary medical intervention. “Death comes from medical reason, not moral reasons” (Kearl 418) for the sake of profit. Evidence points to economic factors that leave the government with the bill. A Congressional investigation in 1977 discloses, “The likelihood of receiving unnecessary treatment is related to one’s position in the status hierarchy. . . . Useless surgery being performed on the needy and the poor [occurs] at twice the rate of that of the general population”(Kearl 419). Needlessly, the useless surgery lead to profits as further evidence reveals “2.38 million unnecessary operations” cause “11,900 needless deaths” and reaps “4 billion dollars” in the process (Kearl 418-419). “In overthrowing . . . the moral [reasons], medicine must now address . . . how patterns of death [relate] to the economic . . . structure . . .”(Kearl 423).
Since life through the health care system “is being . . . sold in the marketplace and distributed on the basis of who can afford to pay for it (Kearl 423),” then it must hold true calculated financial factors determine the value of life. Successively, the value of death must come from the individual through the choice of not buying what is sold.
Not buying what is sold may mean not calling 911. Nine-one-one is a cry for help. If you do not wish help through resuscitation, have your family call the mortuary instead. A call to 911 brings paramedics and police officers. Once the call is made, all attempts possible will be made to resuscitate whether you want that or not. Only the immediate producing of a recorded copy of a Heath Care Power of Attorney can stop an unwanted procedure (the person with the power of attorney must be present to decline help). In addition and as a normal procedure, a police officer investigates the scene to insure no foul play has occurred. To eliminate the hassle, call the mortuary and claim the value of your death.
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