Today's post returns to Lauren Hall's "A Classical-Liberal Response to the Crisis of Bioethics" article published in the Summer 2010 edition of The Independent Review. I originally posted regarding this article on March 8, 2011. I now plan to add 6 additional posts evaluating the 6 sections of the article.
The untitled introductory section of the article uses the unfortunate case of Motl Brady, a 12-year old Hasidic Jew who died in November 2008, to humanize "how out of touch and ultimately irrelevant most of bioethics is to those who are affected by new biomedical technology." A quick summary of the case is as follows: patient brain death on 11/04/08 but heart and lung function maintained by ventilator, physicians asked family to stop life support but parents refused, physicians sought legal order to stop life support, the case gained press attention at which time the bioethics community provided public commentary, and the patient died on 11/16/08 on life support. The public commentary provided by the bioethics community, exemplified by Art Caplan, generally supported the physicians.
The LIBERTARIAN BIOETHICS BLOGger commentary on this case supports liberty. Point #1: Physicians who disagree with the ultimate decision-making of patients and/or their guardians can resign from the case. Point #2: Patients and/or guardians do not have the right to payment from private or public third parties for health care deemed "inappropriate" by the relevant medical practitioners. Point #3: As per point #1, even if patients and/or guardians can pay for "inappropriate" health care out-of-pocket, the disagreeing physicians can resign from the case rather than provide said services. Point #4: Seeking a legal order from a criminal organization (the STATE) to force patients and/or guardians to comply with the opinions of physicians is a criminal act in itself. Point #5: If patients and/or guardians can pay for "inappropriate" health care out-of-pocket and can find physicians to provide said services no intervention to stop the provision of said services should be performed (assuming aggression is not the reason the services have been deemed "inappropriate."
So what should have happened in this case? When the guardians disagreed with the physicians who recommended stopping life support, the relevant third-party payment organization should have been contacted. The relevant third-party payment organization then should have investigated the controversy quickly to make a determination if the organization would pay for the "inappropriate" medical services. If the organization determined it would not pay for the "inappropriate" medical services, the guardians then should have been informed of this fact and advised that the "inappropriate" services would be stopped (due to lack of payment) on a particular date/time. If the guardians could pay for the services or find others to pay for the services then the services should have been continued. If the guardians could not guarantee payment for the services, the services should have been stopped at the previously noted date/time. Problem solved/case closed/liberty is easy.