Art Caplan on Betancourt v. Trinitas

Art Caplan, better than any other bioethicist in the world, can break down complicated ethical and policy issues into digestible compelling chunks of information.  This is what he does for the Betancourt case in an editorial, today, in the Philadelphia Inquirer.

Caplan argues that "the state Appellate Division's punt in this case merits our attention."  He asks: "Should doctors ever be able to decide that medical care is futile and stop treatment regardless of the wishes of a patient's family, friends, or guardians?"  He answers: "It's a huge question, and it will only become more pressing in the years to come, as more and more patients' lives are prolonged with expensive medical technology."

"Although few cases involving medical futility reach court, that doesn't mean doctors don't grapple with them regularly in hospitals and intensive care units." Indeed, Caplan notes, "this nation is likely to encounter more cases like Ruben Betancourt's. . . .  Today these cases are almost always worked out quietly, without lawsuits. In my experience, the hospital usually backs down, and care goes on.  But that may not be the right answer in every case. And doctors, who often feel frustrated by situations they deem futile, don't press to end care for a variety of reasons, including the risk of adverse publicity and the money to be made providing more care."

"It's time," Caplan argues, "to openly and publicly examine what should happen when medical professionals feel they can do no more for patients, but their families, partners, and friends vehemently disagree."