Ending Life Who Should Decide

¶ … Ending Life

Who should decide whether to "pull the plug" in cases like this one: the parents, the attending physician, a hospital committee, or the courts?

The parents should decide but the courts should oversee the decision and consider the input of physicians to ensure that the parents are acting in good faith and in the interest of the child. That is because an adult has the right to refuse medical care or to specify in advance that no artificial means of respiration may be use to keep him alive. Since the child is an infant for whom parents are authorized to make medical decisions in general, in cases such as this, the parents should be able to make the same decision for the child that a competent adult would be permitted to make for himself.

In its Cruzan decision, the U.S. Supreme Court ruled that states can forbid family members to refuse treatment of an incompetent patient without clear evidence that the patient, if competent, would refuse it. Should its ruling apply to patients who, like Samuel, never were competent?

No. Patients who were never competent would always have been dependent on someone else to make medical and other important decisions. The only role of the courts in this situation should be to oversee and make sure that the guardians are genuinely acting out of love and in what they believe to be the best interest of the patient.

Suppose the patient in this case had been an adult who had never expressed an opinion about refusing or accepting treatment in such circumstances. Would his family have the moral right to refuse treatment for him?

Perhaps they would not have a legal right, but I would argue that they still have a moral right to refuse treatment. Absent the expressed position of the patient, nobody would be in better position to make the decision that the patient would most likely have made than his family members. Provided that the circumstances are those under which many people of sound mind would typically choose to refuse continued treatment, the courts should not supersede the family provide the court determines that they are genuinely acting in what they perceive to be his best interests and out of love.

If hospital officials refuse to stop treatment, do family members have the moral right to take matters into their own hands, as Rudolfo Linares did?

I would argue that they do. The only motivation of the parents would be to spare their child from an existence that would either be devoid of any meaningful quality of life or, even worse, an existence of constant discomfort, pain, and confusion. The objective test would be whether or not the prognosis of the patient is either persistent vegetative state or consistent with conditions that reasonable, competent people typically specify they would want to avoid. If competent adults typically choose to direct their loved ones not to continue treatment or to resort to artificial means to maintain biological life, it is perfectly moral for benevolently-motivated parents to want to spare their child that type of existence. The actions of the father were not legal and would not have been moral if they had been motivated by self-interest (such as to collect life insurance or to avoid the medical costs and obligations associated with caring for the child), but if his genuine motivation was benevolent concern for his son, his actions would have been morally pure in an objective sense.

Schiavo and Cruzan Cases: Explain the difference, if any, between the Schiavo and Cruzan cases. Do they then have the same answer?