We fret—rightly—on this blog about the values that inform decisions to pursue or not pursue extensive, risky, intensive, and maybe expensive treatments for severe conditions on the “ends of life.” We’ve written about dismissive attitudes toward the disabled, the escalation of some non-life-threatening conditions (e.g., Down Syndrome) to make them hard barriers to treatment, and so on. We worry, as we must, that a functional view of human moral status will be used, too quickly and in a “blunt object” fashion to create and implement rules that would deny treatment unfairly to those among us who are weak.
One source of correctives against this is sports television. We all know about Oscar Pistorius, the Olympic “blade runner.” (I know he raises issues about enhancement, but I cannot see him as anything but a courageous overcomer when the conventional wisdom would have been to write him off.) But consider also Matt Woodrum, an 11 year old with cerebral palsy, featured on ESPN SportsCenter on Aug 26, 2012. All he did was run, and finish, the 400 meters at his school. When he was a neonate, his parents were told they should have made him a DNR. He had been born three months’ prematurely, with brain hemorrhage. The prognosis was grave for him and his twin brother. In case studies, one might have made an argument for withholding treatment. Or consider Jen Bricker, featured on HBO’s Real Sports with Bryant Gumbel, Episode 184 (registration required to view fully on the Web). Jen was born without legs, and abandoned at the hospital by her parents, who didn’t even bother to name her. She was raised by a saintly couple in a tiny Midwest town. They told her never to say “can’t.” She became a gymnast, a champion tumbler. (She also played softball and basketball (!)) Oh, and she turned out to be the sister of Olympic gymnast Dominique Moceanu.
The point is, especially at the beginning of life, to not give up on people, and to require that medical injury be catastrophic indeed even to consider giving up early. We can consider, as I have suggested on this blog, that in old age we might be wise to forego some treatments in some circumstances, but we should have an extremely powerful bias toward treatment early in life, when earthly possibilities still lie ahead. This bias should recall, as I’ve written before, that “million dollar babies” are not a cost-driver for our health-care finance problems.
Sure, after a reasonable trial of treatment, it may be time to withdraw, but the bias should be strong enough that we don’t have to worry, as Joel Belz does in the current issue of World magazine, that the IPAB or some such body will just declare that kids with Down Syndrome don’t get their congenital heart problems fixed. It just should not even cross our minds.