the New Pantagruel

Harsh Medicine

by Wesley J. Smith

This is a chapter from Culture of Death: The Assault on Medical Ethics in America, by Wesley J. Smith. Reprinted with permission from the publisher, Encounter Books, San Francisco, CA (2000), www.encounterbooks.com.

y mother’s doctor is refusing to give her antibiotics,” the caller told me in an urgent voice.

I asked why.

“He says that she’s ninety-two and an infection will kill her sooner or later, so it might as well be this infection.”

As disturbing as this call was, as outrageous the doctor’s behavior, I wasn’t particularly surprised. I have been receiving such desperate calls with increasing frequency for the last several years. Not every day. Not every week. But with sufficient regularity to know that something very frightening is happening to American medical ethics.

“St. Gregory of Nyssa” (oil on masonite board)
by Kay Darling

Among the more disturbing of such calls I have received was from John Campbell, whose teenage son, Christopher, had been unconscious for three weeks because of brain damage sustained in an auto accident. The boy had just been released from the hospital intensive care unit when he developed a 105-degree fever in the hospital’s “step-down unit.” Campbell asked the nurses to cool his fever. They replied that first they needed a doctor’s orders. Campbell asked them to obtain it, but Christopher’s physician was out of town and the on-call doc-tor said no. “It was an evening of hell,” Campbell says. “My son’s life meant less than hospital protocol. When the doctor refused to order treatment, the nurses said that there was nothing they could do.”

Campbell desperately tried to reach the on-call doctor himself, but the physician refused to take Campbell’s phone calls or respond to his increasingly urgent messages. Meanwhile, Christopher’s condition worsened steadily, his fever rising over a period of some twenty hours, to 107.6 degrees. Finally, the nurses — caught between a desperate father’s pleas and a doctor’s steadfast refusal to treat — insisted that the on-call doctor take Campbell’s call.

Campbell demanded that his son’s fever be treated immediately. The doctor refused. When Campbell grew more insistent, the doctor actually laughed. The boy was unconscious. His life was effectively over. What was the point?

“By this time,” Campbell recalls, “my son’s eyes were black as if he had been in a fight. He was utterly still. He was burning up. The back of his neck was so hot you couldn’t keep your hand on it. I said to the doctor, ‘This is not a joke! This is my son. His life is at stake. His temperature is over 107 and you are going to do something about it.’” Hearing the angry determination in Campbell’s voice and perhaps fearing legal consequences if Christopher died untreated, the doctor finally acquiesced.

Shortly after treatment commenced, Christopher’s temperature subsided. Soon he was moved to a rehabilitation center for therapy and began a slow recovery. Today, he lives at home with his parents where he is learning to walk with assistance. When not in rehabilitation, Christopher works at a local youth center where he feeds animals and counsels at-risk teenagers. Christopher is very glad to be alive-and his parents and the many troubled people he helps every day are glad, too.¹

As I travel around the country speaking in front of various audiences about assisted suicide and other issues involving the ethics of modern medicine, I hear similar horror stories. People are deeply worried about what is happening to medicine: doctors pressured by HMOs to reduce levels of care; hospital nursing staffs cut to the bone; the sickest and most disabled abandoned to inadequate care; elderly people dying in agony in nursing homes because their doctors fail to prescribe proper pain control.² There have even been reported instances of desperate patients in hospitals calling 911 because they were unable to get needed medical attention.³

I believe that stories such as Christopher’s are symptoms of a disintegrating value system in health care, which defines the sickest and most disabled among us as having lives not worth living, which views expensive medical treatments for such people as a waste of valuable resources, and which accepts their demise as a legitimate solution to the difficulties caused by their serious illnesses and disabilities. In short, the ethics of health care are devolving into a stark utilitarianism, which has begun to undermine the “do no harm” credo that has, for millennia, been the cornerstone of medicine.

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