Saturday, February 12, 2011
Last week, Lana Barnes was removed from guardianship of her 85 year old husband, Al Barnes, by a court in Minnesota. The case stemmed from a disagreement over treatment for Al Barnes between his wife and the hospital where he was being kept alive on life-support. Lana Barnes felt that her husband could recover, the hospital disagreed. During the trial, Lana Barnes admitted to having altered her husband's advanced directive.
The case was another example of the challenges faced by families, patients and hospitals when encountering disagreements over the best path of terminal patients. Once again, the courts had to step in to resolve the issue. But my questions are: what if Al Barnes hadn't drawn up an advanced directive? How do we know that Barnes wishes didn't change after he signed his advanced directive? How do patient's protect their end of life choices as they approach the inability to state their desires?
The Pope Doesn't Donate Organs
Many proponents of organ donation used the example of Joseph Ratzinger as an organ volunteer as a selling point. See, donating organs is a good thing! But recently, Polish Archbishop Zygmunt Zimowsky, of the Vatican's health office, clarified that no one will be receiving Pope Benedict XVI's organs. The body of the "belongs to the entire church."
Mitch Daniels Talks Futile Care
Indiana Governor Mitch Daniels touched the Medicare third rail yesterday when talking about how to cut the government program that covers health care for older Americans. Writes Laura Meckler at The Wall Street Journal:
He added that he understands the urge by families to push for what may be futile care. “It’s the most human thing in the world,” he said. “Your loved one is in desperate shape.” He said “we can try this thing that has almost no chance of working” but questioned whether it is worth it, especially given that “it’s going to cost an incredible amount of money.”
It's interesting that a Republican and so many others have this conversation in the framework of cost-cutting and not under the rubric of a more humane consideration regarding futile care: the harm, both physical and emotional that is exerted on family and the patient by futile care.
Daniels stopped short of suggesting, as the Obama administration did briefly, that doctors should be reimbursed for conversations with patients about end of life choices.