Futility of Care

 

The ambulance drove us home June 4th, 2009; Scott returning without having received the antibiotic intervention he needed for his lung infection. Scott had stayed at this same hospital for his Tracheotomy surgery just 2 months prior; on file they had the documentation of Scott’s Advanced Directives, Power of Attorney and P.O.L.S.T statement (Physicians Order for Life Sustaining Treatment). A checkbox within this statement informs medical personnel NOT to refuse antibiotics if life can be prolonged; Scott consented to all interventions, those were his wishes. Considered “Full-Code” his POLST was signed the month prior, incidentally, by the pulmonologist on-call who gave the orders to send Scott home without antibiotic treatment.

I could not comprehend the Emergency Room sending Scott home as if he didn’t merit any further efforts from the physicians-the qualified practitioners we all go to for assistance in times of health crisis. This experience was my first introduction to what is considered futile care “the belief that in cases where there is no hope for improvement of an incapacitating condition, that no course of treatment is called for.”

I spent the next several weeks after our hospital encounter in June delving into the arguments of Futility of Care and Passive Euthanasia. Futile Care could be defined as care that fails to achieve benefit. Although there is no generally accepted medical definition of “futile care” a physicians’ assessment allows a medical establishment to withdraw or withhold treatment measures and instead dispense only “comfort (palliative) care”. The same determination not to treat is also the criteria for initiating hospice care for persons with less than six months to live. Passive euthanasia is another term defined as “the withholding of common treatments, such as antibiotics, necessary for the continuance of life.”[1] Treatment decisions may be established on unexpressed assumptions about prognosis and quality of life, basing decisions and recommendations on the practitioner’s personal moral values. The patient’s life may be viewed as not “workable” or worth treating.

Both of these issues present personal and controversial ethics concerning social and religious values. Diminishing a person’s life and worthiness collides with my knowledge of God’s love for each living soul. I’m saddened at the awareness that many elderly and otherwise helpless people (and their loved ones) experience this harsh actuality and end-of-the-road realization many families have to face. I had not been aware of this cruel reality up until Scott was sent home from the hospital with no treatment although fighting an infection and unable to breathe. Room must be made for those who can be helped. Instead time, resources, insurance coverage and allowances dictate. We may acknowledge validity of these limitations; however, when your loved one is the one being refused care brings home the anguish that you are powerless to help and those that can….wont.

Most of our lives we don’t give much thought to these matters until we are made painfully aware because of the life threatening conditions of those near to us. Perhaps that’s why it hit me so hard; it seemed that Scott was being classed as a futile case although He has never been on hospice care. His spirit and his will to live was/is so strong. We simply went to the hospital because of Scott’s lung infection. Unfortunately, because of Scott’s terminal diagnosis and the interventions he has already had, I no longer have confidence to take Scott the hospital. I suspect the medical plan at best would be comfort or hospice care.

In the midst of my discouragement, I am reminded that God is the Great Physician and Scott is ultimately God’s patient. If He intends to continue to lengthen Scott’s days, HE WILL!

“that we were burdened excessively, beyond our strength, so that we despaired even of life; indeed, we had the sentence of death within ourselves so that we would not trust in ourselves, but in God who raises the dead; who delivered us from so great a peril of death, and will deliver us, He on whom we have set our hope. And He will yet deliver us” 2Cor 1:8b-10 NASB

SCOTT BRODIE June 2009 Sent Home

Glennis tells of Scott being denied IV antibiotics and admittance to hospital

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[1] Wikipedia®, updated 14 August 2010

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