END-OF-LIFE CARE: El Camino Hospital Proposes Major Policy Change
El Camino Hospital in Mountain View "is considering a new policy that would allow doctors to cut off medical treatment to patients if they consider their case hopeless, regardless of family wishes," the AP/Sacramento Bee reports. The policy "has already been approved by the hospital ethics committee," but still needs approval from other hospital committees. Final approval of the "so-called futile-care proposal" must come from the "public hospital's board of directors." Under the proposal, "families and patients have the right to refuse treatment, but not to demand it." If there is disagreement between the doctors and family over treatment, the hospital's ethics "committee would decide," and "[i]f that didn't work, the patient would be sent to another hospital." Dr. John Longwell, head of the hospital's ethics committee, noted that "it is sometimes up to the doctor to do what the family cannot." He said, "When patients are dying, some families will say, 'I want you to try one more time.' We feel it's assault and battery -- it's not treatment."
The Bee reports that hospitals in the San Francisco Bay area already have similar policies and last year "the Santa Clara County Medical Association approved a policy identical to the one being considered at El Camino Hospital." Dr. Lawrence Schneiderman, a University of California-San Diego medical ethicist, said, "Hospitals are beginning to say ... 'You have a right to refuse treatment, but you don't have a right to demand treatment. Our job is to benefit the patient, not keep doing things nature doesn't want us to do." According to the California Medical Association, no current state or federal laws "directly address the legality of a doctor's right to withhold care in futile cases." However, Dr. Wendell Ferguson, El Camino's chief of staff, "said he wouldn't sign the policy the way it is worded now." He said, "I worry about the slippery slope. Once you get used to the idea that terminating life is a humane thing to do, it's easier to do it more and more. It might not be so bad to err on the side of keeping people alive a bit longer" (5/27).