Appel on Betancourt v. Trinitas Hospital

Today, in the Huffington Post, bioethicist and medical historian Jacob M. Appel strongly and eloquently defends the hospital's position in Betancourt v. Trinitas Hospital.  He rightly observes that the case “offers an excellent vehicle for the courts to clarify the circumstances under which hospitals may override patients and families.”

Appel links the issues in the case to the nomination of Donald Berwick and the broader rationing debate:  “Every dollar exhausted on patients who will never wake up again is a dollar not devoted to finding a cure for cancer. While the visible victims may draw the headlines and attract indignant protests from so-called "pro-life" organizations, the invisible victims are people like you and me who will suffer from diseases that are never cured because funds are being poured down a healthcare sieve in order to maintain permanently-unconscious bodies on complex and costly forms of life support.”

Appel also defends a standard like the “minimum goal” of the Manitoba College of Physicians and Surgeons:  “In essence, the Betancourt court can decide that physicians and taxpayers only have a duty to provide unlimited care to patients who have a meaningful chance of returning to consciousness. Let us make no mistake about what this would mean: It would mean declaring that the lives of PVS patients are worth less than those of others. Rather than shying away from this outcome, progressive bioethicists should have the courage to acknowledge and to embrace this proposition.”