Sticky ethical question

[future_doc]

you've really outdone yourself on this thread, f_d

 

Finally, we agree on something. It is quite exhausting though:o .

[AndrewB]

Finally, we agree on something. It is quite exhausting though:o .

 

This thread is making my **** soft.

 

/end

[w8kg6]

Just a sidenote, this turned into the 11th most replied to thread in the general forums. That was definitely unexpected, heh.

[The Law]

lol what a relief it must be to finally find someone even younger than you law..but don't forget you already have a son

 

Yes, our very own little bundle of joy.

[Rayven]

(10 characters)

 

Rayven, are you sure you not writing the LSAT? hehe You may wish to consider both law and medicine, I recently saw that one 25 year old guy is about to graduate from both (in US) and he plans to practice in each profession and then perhpas stick to law in malpractice.

Oyyy.. good grief. All I've been trying to get out of you is an answer. Not another side-step... maybe you should go on Dancing With The Stars?

 

So blonde or possibly brunette bombshell? I hope that wasn't sarcasm otherwise...

[LostLamb]

Just a sidenote, this turned into the 11th most replied to thread in the general forums. That was definitely unexpected, heh.

 

ONLY the 11th most replied to thread? How disappointing, I would have thought we'd made the top ten.

 

If nothing else, I hope it has given those following it food for thought. w8kg6: kudos for bringing your thoughts and starting the thread.

[future_doc]

I hope that wasn't sarcasm otherwise...

 

Absolutely not, I was being complimentary. You are tenacious, consistent, demanding, focused and smart - all good traits of an excellent lawyer. Ergo, you could be in med., law or both. MCAT will be sort of a validation test for us both, to determine when we go to the next step.

[Rayven]

Absolutely not, I was being complimentary. You are tenacious, consistent, demanding, focused and smart - all good traits of an excellent lawyer. Ergo, you could be in med., law or both. MCAT will be sort of a validation test for us both, to determine when we go to the next step.

lol... I was asking if you were being sarcastic about your looks.

 

But thanks. You're nice too.

[future_doc]

ONLY the 11th most replied to thread? How disappointing, I would have thought we'd made the top ten.

 

If nothing else, I hope it has given those following it food for thought. w8kg6: kudos for bringing your thoughts and starting the thread.

 

Every time we think the thread is over, somehow it comes back to life, so who knows?

 

What is amazing is that if we factor in time considerations, this thread exploded quite quickly.....and it must be a record there be it no. 11 or no. 10.

 

Yes, well done for us all, especially to the originator.

[future_doc]

lol... I was asking if you were being sarcastic about your looks.

 

But thanks. You're nice too.

 

Absolutely not, the truth always reveals itself. You asked a straightforward question and I answered you honestly, it is what it is. NewfieMike compared me to another poster some time back and he did not know how accurate he was. On the list of priorities of people comes compassion, values, sense of humour, intelligence, common sense, good judgment, initiative, personable and looks are way down and less important (to some of us anyhow), life is sort of like a MMI where we are making assessments of others based upon their beaviour and jiudgment in real life situations.

[future_doc]

Just a sidenote, this turned into the 11th most replied to thread in the general forums. That was definitely unexpected, heh.

 

As ther "title" is generic, we can keep it alive by finding other ethical issues to discuss, there are so many.

 

As a sidenote, also looking at the audience viewing, it is quite an accomplishment. And remember, this all occurred in just a few days, not a month or so. Well done.

[future_doc]

avenir and The Law made their occasional contribution by adding to the light side on this thread.

 

However, somehow we avoided a hijacking.

[future_doc]

I continue to be bothered by the suggestion that in Canada a person with severe mental and/or physical impairment could conceivably be euthanized or not given the basic care and/or treatment to sustain life. The Canadian Charter of Rights and Freedoms nowhere suggests or implies that Canadians with certain conditions have lesser rights than other Canadians due to financial considerations. The reality is that the healthcare system in run and funded by the public purse. And the public purse has no right of discrimination against our citizens who need most the healthcare system for their support, care and their very lives. The thought of imposing euthanasia upon any of our citizens is abhorrent to civilized humanity. Section 7 of the Canadian Charter of Rights and Freedoms does away with the argument and reads as follows:

 

S. 7 Life, liberty and security of person

 

Everyone has the right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice.

 

As regards giving these people a lesser treatment, I quote from Section 12:

 

S. 12 Treatment or punishment

 

Everyone has the right not to be subjected to any cruel or unusual treatment or punishment.

 

Section 15 gives us all equality:

 

S. 15 Equality before and under the law and equal protection and benefit of law.

 

S. 15(1) Every individual is equal before and under the law and has the right to equal protection and equal benefit of the law and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability.

 

 

And Sections 24 and 26 round it out:

 

S. 24 Enforcement of guaranteed rights and freedoms

 

S. 24(1) Anyone whose rights or freedoms, as guaranteed by this Charter, have been infringed or denied may apply to a court of competent jurisdiction to obtain such remedy as the court considers appropriate and just in the circumstances.

 

S. 26 Other rights and freedoms not affected by the Charter

 

The guarantee in this Charter of certain rights and freedoms shall not be construed as denying the existence of any other rights or freedoms that exist in Canada.

 

 

In other words, the arguments of forced euthanasia have no place in our society. And for physicians to use financial considerations to trade lives for money is going down into the abyss ethically, morally and legally.

[future_doc]

Okay guys, you are so keen to sacrifice one life to save a hundred. It is easy for you to sacrifice that other person's life to save others.

 

Well, what if the life that has to be sacrificed is yours. Of course, this is all theoretical, but are you prepared to sacrfice your own life if you could save others..and nobdy knew...you would just cease to exist. disappear from all loved ones, nobody would know why, just all gone. No more future, but your last thought would perhaps be knowing that you saved others. WShat do you think?

[Rayven]

Geez... someone's racking up the post counts tonight. We've already passed the quadruple posts now. >.>

 

future_doc, for future_reference you can edit your posts.

 

You asked a straightforward question and I answered you honestly, it is what it is.

You like.. never.. answer my questions. -.-

 

Anyways, like I said before, the euthanasia debate died really early on in this debate. I also don't think anyone has been questioning the rights and freedoms that people are entitled. At least, not from what I've been reading from this thread. It seems to me that we've been debating if it's ethical to be using so much resources (financial and human) to sustain one life when it could be used to save many.It's not an easy choice and I've already said that before.

 

While we're on the topic of the Charter of Rights and Freedoms, which is very much like it's brother the US Constitution, I get the gist of these documents is that we're all generally entitled to our own freedom and liberties as long as it doesn't inflict or impose harm onto others. And although it seems a lot less direct, when you have a patient taking up a considerable amount of resources (financial and human), we should realize that in our society of finite resources that someone somewhere out there is losing out. With respect to health care, what comes to mind for me is people without a family doctor, longer wait times to see a specialist or get an MRI, that sort of thing.

 

Just my thoughts.

[Microbiodude]

Okay guys, you are so keen to sacrifice one life to save a hundred. It is easy for you to sacrifice that other person's life to save others.

 

Well, what if the life that has to be sacrificed is yours. Of course, this is all theoretical, but are you prepared to sacrfice your own life if you could save others..and nobdy knew...you would just cease to exist. disappear from all loved ones, nobody would know why, just all gone. No more future, but your last thought would perhaps be knowing that you saved others. WShat do you think?

 

cease to exist? Where do you think we live? It's not like the RCMP is going to kidnap you in the middle of the night and not notify any family members, and then erase all records of your existence from every government and private database. More than likely the CBC/ media would catch wind of it publicize it and we would have a national debate. You as the challenged individual most likely won't know what's going on and just think the doctor is performing some sort of medical test/ giving you a needle and your family is crying for some reason you don't know.

 

However, lets say I was suffering from another chronic condition that kept my mental capacity intact but severely diminished my quality of life and I realized my care took a significant toll on the health care system...well without any hope of recovery I would probably sacrifice my life.

[future_doc]

However, lets say I was suffering from another chronic condition that kept my mental capacity intact but severely diminished my quality of life and I realized my care took a significant toll on the health care system...well without any hope of recovery I would probably sacrifice my life.

 

Understandable.............what if the healthcare system was so clogged that it could not get to treat you or operate on you just b/c of dealy.......the argument goes, healthcare delayed is healthcare denied contrary to our enshrined rights of "fundamental justice" guaranteeed by the above quoted Charter - see http://www.coa-aco.org/pdf/coa-bulletin/issue-65/hollinshead-chaoulli-fundamental-justice.html for discussion of this issue, including position of CMA.

[Microbiodude]

Understandable.............what if the healthcare system was so clogged that it could not get to treat you or operate on you just b/c of dealy.......the argument goes, healthcare delayed is healthcare denied contrary to our enshrined rights of "fundamental justice" guaranteeed by the above quoted Charter - see http://www.coa-aco.org/pdf/coa-bulletin/issue-65/hollinshead-chaoulli-fundamental-justice.html for discussion of this issue, including position of CMA.

 

Yes...that would further support proponents of not supporting one individual at $300K but a 100 dialysis patients instead. The idea is by redistributing funds we reduce wait times and improve access to health care for many more individuals and consequently deny less individuals of needed healthcare.

 

If we go back to my dialysis example, would you deny healthcare to 100 individuals to save one?

[future_doc]

If we look at the Charter provisions, they deal with sanctity of life and not money, so I would go to Court to ensure that all patients receive fundamental justice and receive what they require.

[Microbiodude]

ALL patients receive what they require...I didn't know the courts had the power to make money multiply. So what you're saying is that the next time my $300K HIV grant application gets denied and goes to the oncology department I should take it to the courts and ask them to create $300K for me as well so that BOTH Cancer and HIV research are funded.

 

If we take money out of the equation, since its really the middle person here, the actual trade that's going on is the one mentally challenged individual costs 100 dialysis patients/ year to take care of...is that ethical?

 

I'll put you in the hot seat, you are on the healthcare spending committee and you have $300k to give to one service. Do you give it to:

 

A) The renal ward to treat 100 dialysis patients

The Social Service Organization that is helping one mentally challenged patient

C) Can't choose and as such nobody gets funding

 

Please select one of the following options.

[future_doc]

ALL patients receive what they require...I didn't know the courts had the power to make money multiply. So what you're saying is that the next time my $300K HIV grant application gets denied and goes to the oncology department I should take it to the courts and ask them to create $300K for me as well so that BOTH Cancer and HIV research are funded.

 

If we take money out of the equation, since its really the middle person here, the actual trade that's going on is the one mentally challenged individual costs 100 dialysis patients/ year to take care of...is that ethical?

 

I'll put you in the hot seat, you are on the healthcare spending committee and you have $300k to give to one service. Do you give it to:

 

A) The renal ward to treat 100 dialysis patients

The Social Service Organization that is helping one mentally challenged patient

C) Can't choose and as such nobody gets funding

 

Please select one of the following options.

 

These problems are predictable and preventable. ALL these patients have rights under the Charter and the government assumed and in any event has the responsibility to provide timely treatment. As physician, my responsibility is to treat patients, the government responsibility is to find the funding. I would take an action against the government based on Charter rights way in advance of the problem. If I have several patients requiring medical assistance, I will deal with those requiring treatment first to save their lives. I would never sit on a healthcare spending committee, although I would sit in Cabinet.

[future_doc]

Geez... someone's racking up the post counts tonight. We've already passed the quadruple posts now. >.>

 

future_doc, for future_reference you can edit your posts.

 

I am sure you noticed that each post was in a different time frame and covered differing topics. Therefore, it is reasonable that they should not be placed together in one post, however, I am prepared to leave it to a poll decision, lol.

 

This post is entirely unrelated to my post immediately above as a simple example.

[Microbiodude]

You realize a cabinet member would be part of the Healthcare Spending committee right (i.e. the Heath Minister)?

 

http://en.wikipedia.org/wiki/Minister_of_Health_(Canada)

 

In fact these kind of decisions would be exactly what you would face as a cabinet minister. Where to put the people's money.

[future_doc]

You realize a cabinet member would be part of the Healthcare Spending committee right (i.e. the Heath Minister)?

 

If that is the case, I would direct that all these patients receive treatment immediately, there would be a political and financial crisis, the citizens would agree with this, heads might role including mine, if the Cabinet tried to reverse me, I would go to Court and this debate would be read by all citizens every day until it was resolved quickly.

[future_doc]

see http://www.ldac-taac.ca/ldandthelaw/casesAuton_Law-e.asp that gives rights to students with autism. If a government fails to ensure that adequate treatment for autism is available for children, this failure is discriminatory and amounts to a violation of the Canadian Charter of Rights and Freedoms.

 

There is also discussion of "The Application of the Canadian Charter in the Health Care Context" by Martha Jackman, found at http://www.law.ualbert.ca/centres/hli/userfiles/jackmanfrm1.pdf (which I only just found and have not yet had a chance to read and digest).

 

See http://www.bcmhas.ca/NR/rdonlyres/F3A987AC-F436-4137-89BF-E6B2509486B6/25319/RVH_Charter_of_Patient_Rights.pdf which is the Riverview Hospital Charter of Patient Rights. In Part 1, it states, "These r9ights are to be interpreted within the Hosptial's responsibility to provide a safe and therapeutic environment for all patients within the available resources.

 

Of course, it becomes a matter of law, what resources must be provided by the government that may not be willing to provide financial rresources to certain treatment, for example the treatment of autistic children. Recourse is made to the Courts to force the government to provide the necessary financial resources.

 

 

There is an interesting discussion of bioethics, international law, the Charter and Canadian law at http://books.google.com/books?id=zIDmNVIHIAC&pg=PA312&lpg=PA312&dq=Canadian+Charter+of+Rights+for+medical+treatment&source=bl&ots+zxal5rak9s&sig+ZjgslblEHI*dmovexp6aj5Olrqc&hl=en&ei=4BV_Sr7BH42cMN7VOP4C&sa=X8oi=book_result&ct=result&resnum=6#v=onepage&q=&f=false reviewing a book "Autonmoy and Human Rights in Health Care" by David N. Weisstub, Guillermo Diaz Pintos