Many of us who follow the biomedical scene with regard to right to life issues have long believed that the "right to choose" is really a one-way street. We hear all the time about the "right to choose" not to receive treatment, resuscitation, or "life-extending measures," but all the rhetoric suggests that the people shouting "choice" would be singing a different tune if the choice were to receive the measures they obviously disdain. In such discussions the life-sustaining measures are almost always negatively portrayed as "being hooked up to machines" (even when this is false and there are no machines), "being hooked up to tubes" (aka, receiving food and water by tube feeding), and "being kept alive." As we saw here, "being kept alive" is now even used to refer to a person suffering from dementia who is apparently willingly receiving mere spoon feeding. And then, of course, there are all the extremely derogatory ways of referring to the disabled patient himself.
So is choice really the important thing, or is the really important agenda making sure people make the "right" choice, the "rational" choice (to die)? Is "freedom to choose" just a fraud, intended to lure people to their deaths? Many of us have thought so for a long time.
Let me pause for a moment to explain again the "choice devours itself" phenomenon. Choice devours itself when someone touts the need to make some choice available, allegedly for the benefit of some identifiable group who needs to choose that outcome. Then, however, we find that some of the very people who were to be benefited are actually being forced into the so-called "choice," but the original advocates of choice as the greatest good either don't care, actively approve of the coercion, or are in denial about its occurrence. So their love of choice turns out to have been a sham.
This happens with regard to coerced and forced abortions, human sex trafficking, and, of course, death.
Now, South Australia has amended its medical laws so that they expressly affirm that the only choice allowed is the choice for death and that a choice for life need not be honored. The Advance Care Directives Act 2013 reads,
(2) A medical practitioner responsible for the treatment or care of a patient in the terminal phase of a terminal illness, or a person participating in the treatment or care of the patient under the medical practitioner's supervision—
(a) is under no duty to use, or to continue to use, life sustaining measures in treating the patient if the effect of doing so would be merely to prolong life in a moribund state without any real prospect of recovery or in a persistent vegetative state (whether or not the patient or the patient's representative has requested that such measures be used or continued); and
(b) must, if the patient or the patient's representative so directs, withdraw life sustaining measures from the patient. (emphasis added)
It doesn't get much more explicit than that, does it? The article which reports this amendment (in a postscript) says that this removes a previous "confusion" in the law as to whether doctors have to provide what they deem to be "futile" care for patients. Well, thanks for clearing that up, folks. Now we know that futile care theory reigns. If you choose death, then choice is sacrosanct and the doctor must respect that choice. If you choose life, even where this simply means continuing to receive sustenance, the medical profession can refuse.
Notice that this would apply even if the patient had an advance directive (as some of us do) which expressly says that we do wish to receive, say, tube feeding if necessary. Remember all that talk about how we should all avoid these agonizing end-of-life debates by running right out and "making our wishes known" in an advance directive? Yes, well, in South Australia they're making it quite clear that it was all a lie. Eventually the lie becomes unnecessary.
As Wesley J. Smith says (from whose blog I got the story):
For those who take comfort because they don’t live in South Australia, understand that these laws are as catching as a virus.
That's an important point. Let's not fool ourselves. The ethical "professionals" in the United States are committed to the same worldview that lies behind this law in South Australia. There is not some kind of deep cultural divide there. The world is a very small place, especially when it comes to sub-fields like bioethics. There is no question but that the ethics committees in hospitals in the United States believe that they should have the unilateral power to do what this Australian law describes--to refuse to honor what they regard as "irrational" decisions to remain alive in a state they deem unworthy of life. Nor, as this case shows, is this always about money or "demanding things for which one has no ability to pay," though money often does come into play and will do so even more as America moves more and more into a socialized medical situation. But in young Zach's case, his family had medical insurance. No, it's about power. And it's about thinking that people who want to live or who want their loved ones to continue to live "like that" are irrational.
It's about choice devouring itself.