Basic Care, Human Dignity, and Care for Medically Vulnerable Persons

(Charlotte Lozier Institute) – Earlier this year, Oregon’s state legislature considered a bill that would have increased the number of medically vulnerable persons at risk of an untimely death. Oregon’s SB 494 would have redefined food and water delivered by a cup or spoon—everyday utensils—as a regulated, physician-controlled form of “medical care” rather than the “basic and ordinary” care that common sense suggests. In Oregon, patients who are awake, conscious, and aware—but were unable to feed themselves due to disability, brain injury, or lack of physical mobility—would have faced the real chance of being denied food and water.[i] Fortunately, despite Oregon’s Senate passage in a 17–13 vote, the House referred the bill to a committee where it was tabled for the session.

However, as disconcerting as such a bill is, a much less understood and equally pernicious reality is this: It is already legal in every state to withhold or deny food and water by means of a feeding tube to patients who are not actively dying and not facing any active “end of life” issue.[ii] In simpler terms, it is presently legal in every state deliberately to bring about the end of a patient’s life by denying a nonterminal person food and water. We tend to call these “end of life” cases—but that’s often papering over the fact that it was our medical system that sought to end their life. This practice flies in the face of human and medical experience, which has long held that so long as someone could metabolize food and water, then it would be wrong to deny them this vital and basic form of care. A landmark 1986 California case, Bouvia v. Superior Court set precedent for classifying food and water as “medical treatment” depending on the circumstances of its consumption.[iii]

Wesley J. Smith, author, attorney, and bioethicist, has written compellingly on the essential issue connecting nourishment and medically vulnerable persons. “Does every human life have equal and incalculable moral value simply and merely because it is human?” asks Smith. “Answer yes, and we have a chance of achieving a truly humane, free, and prosperous society. Answer no, and we are just another animal in the forest.”[iv] So many of us unconsciously embrace a utilitarian sort of ethical perspective, where we judge the quality of one’s life by what someone can do or by another arbitrary determinant. Embracing Wesley J. Smith’s broader and more liberal understanding of human dignity is today a radical act of love and empathy for medically vulnerable persons—but understanding how we came to this point requires taking a few steps back in time. CONTINUE