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Who decides when life ends?

Thinking it Through

Jahi McMath, a 13-year-old girl whose routine tonsillectomy turned into a coma, may be dead by the time this column is published. But her parents refused to accept the judgment of Children’s Hospital Oakland that she was already dead and sought to remove her from that institution and seek treatment at another, possibly in New York.

Not since Terri Schiavo suffered brain damage and was judged to be in a “vegetative state” has such public attention been focused on a patient thought to be beyond hope or the powers of modern physicians. Schiavo died on March 31, 2005 after her husband won a court battle to cut off her nutrition, even though she showed signs of life in her facial movements and was not on a ventilator like Jahi McMath.

In these cases the facts matter very much, but morality no less, and doubtless even more. For without a moral compass, even the smartest person can — and often does — go wrong. The most pressing fact is not the condition of the patient but the moral climate of the hospital.

As has been long known, an increasing number of hospitals, advised (or confirmed) by so-called medical “ethicists,” have wrested control of decision-making from patients’ loved ones in their determination to save only human lives with “quality,” a slippery standard designed to justify end-of-life decisions by the “experts.”

Each time anyone is admitted to a hospital for even the most minor procedure, a consent form is presented which must be read carefully, notwithstanding pressure to sign all forms to get things moving. In my opinion, no person should ever consent to the denial of nutrition and hydration, for comas are not always irreversible. Organ failure may be unavoidable but starvation and dehydration are not.

When my mother-in-law suffered a stroke nearly 14 years ago, nurses at the hospital to which she was admitted actually told us that they were cutting off food and water. Advised by our lawyer son to reject this decision, my wife and I insisted on feeding tubes and fluids. She died in four days but at least we knew that we didn’t contribute to her death by speeding up the natural process.

Terri Schiavo survived as long as she had such assistance, but her husband’s determination to be free of her custodial and hospital care carried the day. The parents of Jahi McMath, while facing longer odds, have had more legal success than the parents of Terri Schiavo.

Does race matter in these cases? Just asking.

But besides the fact that the McMath family is entitled to make its own decisions in their daughter’s case we should support them in their determination to get a second opinion! A hospital which botched a routine tonsillectomy is not on very solid medical ground — not to mention moral ground — when it insists that the girl is dead. At the very least, it owes the family both an apology and substantial restitution for the loss of their daughter, whether or not she persists in her accidental unconsciousness.

Unless ObamaCare is repealed, its implementation in cases like Terri Schiavo’s and Jahi

Math’s is completely predictable. A panel of bureaucrats with no claim to medical expertise or ethical principles will weigh in with the claim that the limited resources of the nation do not support any patient whose condition fails to meet the “quality of life” standard. That’s why they’ve already been called “death panels.”

It is fashionable to sneer at such criticisms, but this is to miss the forest for the trees. Ever since Roe v. Wade struck down all state restrictions on abortion 41 years ago this month, a culture of death has come to dominate our institutions. Those who are living have the absolute power to determine whether the yet-to-be-born or the disabled and diseased will continue to live.

Absent such a culture, it is at least arguable that the Affordable Care and Patient Protection (!) Act would not confer life and death power in government agencies. But the blood is in the water, so to speak, and the sharks are circling. Otherwise, doctors would be loath to make public statements that a young girl is dead when her parents insist that she is not.

One of ObamaCare’s main advantages was supposed to be bringing down medical costs.That claim is laughable in the face of its disastrous rollout in which the young and healthy are avoiding enrollment because of the exorbitant cost while the poor, sick and elderly are paying little or nothing. But the green eyeshades routine will surely kick in for people who long ago abandoned any commitment to the idea that human life is sacred or that every human being has a right to life.

Richard Reeb taught political science, philosophy and journalism at Barstow College from 1970 to 2003. He is the author of "Taking Journalism Seriously: 'Objectivity' as a Partisan Cause" (University Press of America, 1999). He can be contacted at

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