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Futile Treatment Disputes Like Ordering Off the Menu

Posted Sep 22 2008 5:56am

There are many reasons that providers resists some treatment requests by surrogates. They distrust the surrogate is acting in accordance with the patient's wishes or best interests. They think the requested treatment will cause suffering. They think that providing the requested treatment violates their professional or personal ethics. Or they might think that providing the requested treatment is a waste of hard or soft resources.

The Golubchuk dispute was framed as a dispute over whether providers had to provide treatment that they felt was inconsistent with their roles as medical professionals. Grace Hospital and the critical care providers were basically saying, "Dear family of Sam Golubchuk, you are asking we medical professionals to do something that we just don't do. It's just not part of the services that we offer or provide."

The providers were not saying that Golubchuk ought not be able to receive the treatment his family requested. They did not want to criminalize it (like laetrile or like abortion in the 1960s). They just did not want to be involved. One might say that it is like ordering osso bucco in a vegetarian restaurant. There is nothing wriong with cooking, ordering, or eating osso bucco. But that does not mean a customer should sit down at a table in a vegetarian restaurant and order it. Not only is osso bucco not on the menu but serving it is inconsistent with the very mission of the restaurant.
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