A High-Profile Bioethicist!?!

What did these parents feed their children? One is White House Chief of Staff, one inspired an HBO show about Hollywood agents, and the another has become maybe the first ever famous bioethicist. 

The insanity of all of that aside, this NY Times piece on Dr. Ezekiel J. Emanuel and his role in advising President Obama's on healthcare legislation is a great read. If for no other reason, it is yet another example of how issues that need to be carefully, reasonably discussed get spun out into crazy, maddening, thoughtless rhetoric in the political arena.  

Palliative Care Grand Rounds, Volume 1, Issue 6

This month's edition of Palliative Care Grand Rounds is now up at Tim Cousounis' blog Palliative Care Success. 

It offers a great look at what has been happening in the blogosphere this past month regarding end-of-life issues. And he very appropriately begins it within the framework of health-care reform and bioethics discussions ... because isn't that what's on everyone's mind right now?

Please take a few moments to check it out. 

Parental Decision Making and Faith Healing

While I'm on a bioethics thread ... I've been reading up on this case in Oregon. 

Parents Carl and Raylene Worthington are being charged with manslaughter in the death of their 15-month-old daughter because they refused to seek modern medical treatment and instead opted for faith healing. 

The child had bronchial pneumonia and a blood infection, both of which the Oregon State Medical Examiner's officer have concluded could have been treated with antibiotics.  

I think it's always unfortunate when the state and the medical system have to interfere in the decisions of an individual family, but when the life of a child is at stake, sometimes it has to be done. Because, let's think about this, you don't want to interfere because of, first or all, the family's autonomy. Also because the parents should know the children the best and have their best interests at heart. Parents should be, and usually are, their child's greatest advocates. 

In the rare cases when the parents are making decision that clearly put the child at great risk, I think it's the responsibility of the state and the medical team to step in on behalf of the minor. 

It really doesn't seem fair to subject the child to religious beliefs that risk their life when they're yet too young to decide those issues for themselves. 

The Worthington case is even more complicated because the state isn't merely intervening in care; the parents are being brought up on criminal charges after the child's death. Oregon actually has a law that makes it illegal to rely solely on faith healing when you have a sick child who needs medical help. 

It will be interesting to watch how this unfolds—to see if the parents are convicted, and also to see if the law is amended at all now that it is facing its first real application.

Here's a great link for further reading on the ethics parental decision making in the medical process, if you're interested. 

Physician Assisted Suicide—Follow-Up

Some more information on Physician Assisted Suicide:

First, here is a link to an excellent resource on how to examine PAS through an ethical framework. It is the University of Washington's Bioethics website. I worked on the site back in 2002/2003. It is geared toward helping medical students learn to handle situations that will likely emerge once they become doctors, but I think the discussion can apply to anyone who is interested in picking apart this topic more fully. And it gives ethical arguments for BOTH SIDES.

Second, one question I have heard raised a lot on other blogs is why proponents of I-1000 don't just call what they are advocating for euthanasia. I'd like to explain that briefly. Euthanasia and PAS are two distinct terms. Euthanasia can be used to describe ending a life in a painless manner, a mercy killing if you will, but a euthanasia is actually performed by the medical personnel. In the case of PAS, a prescription is handed out by the doctor, and pills are given to the patient for the patient to take home and bring about death on their own. I'm not saying one is better than the other, just that there is a technical distinction.