I don’t want to go on the cart

by the Night Writer

There is a Monty Python-esque air to the current healthcare debate as I picture anyone actually reading the particulars of Obama-care striking themselves regularly in the forehead with the bill, ala the hooded monks in the opening of Scene 2 in Monty Python and the Holy Grail.  Of course, the rest of that scene bears an uncanny resemblence to the proposed care as well, as I noted back in 2005 in a post entitled “21st Century British Healthcare.” Things really haven’t changed much since 2005, or since 1100 for that matter:

(Monty Python and the Holy Grail, Scene 2)
CART MASTER: Bring out your dead!
CUSTOMER: Here’s one.
CART MASTER: Ninepence.
DEAD PERSON: I’m not dead!
CART MASTER: What?
CUSTOMER: Nothing. Here’s your ninepence.
DEAD PERSON: I’m not dead!

Terminally Ill Can Be Starved to Death, UK Court Rules
By Nicola Brent, CNSNews.com Correspondent, August 02, 2005(CNSNews.com) – An appeal court has denied a terminally ill British man the assurance that his wish not to be starved to death once he becomes incapacitated will be respected to the end.

Former mailman Leslie Burke, 45, has a progressively degenerative disease that although leaving him fully conscious, will eventually rob him of the ability to swallow and communicate.

He petitioned the High Court last year to ensure that he would not be denied food and water once he was no longer able to articulate his wishes.

CART MASTER: ‘Ere. He says he’s not dead!
CUSTOMER: Yes, he is.
DEAD PERSON: I’m not!
CART MASTER: He isn’t?
CUSTOMER: Well, he will be soon. He’s very ill.
DEAD PERSON: I’m getting better!
CUSTOMER: No, you’re not. You’ll be stone dead in a moment.

Burke won that right when judge James Munby ruled that if a patient was mentally competent — or if incapacitated, had made an advance request for treatment — then doctors were bound to provide artificial nutrition or hydration (ANH).

But last May, the General Medical Council (GMC) — the medical licensing authority — took the case to the Appeal Court, arguing that doctors had been placed “in an impossibly difficult position.”

The appeal judges have now agreed, overturning the High Court judgment and upholding GMC guidelines on how to treat incapacitated patients.

CART MASTER: Oh, I can’t take him like that. It’s against regulations.
DEAD PERSON: I don’t want to go on the cart!
CUSTOMER: Oh, don’t be such a baby.
CART MASTER: I can’t take him.
DEAD PERSON: I feel fine!

Those guidelines give doctors the final say in whether a patient should be given life-sustaining “treatment,” a term legally defined to include artificial feeding or hydration.

The latest ruling obliges doctors to provide life-prolonging treatment if a terminally ill and mentally competent patient asks for it.

However, once a patient is no longer able to express his or her wishes or is mentally incapacitated, doctors can withdraw treatment, including ANH, if they consider it to be causing suffering or “overly burdensome.”

Ultimately, the court said, a patient cannot demand treatment the doctor considers to be “adverse to the patient’s clinical needs.”

CUSTOMER: Well, do us a favour.
CART MASTER: I can’t.
CUSTOMER: Well, can you hang around a couple of minutes? He won’t be long.
CART MASTER: No, I’ve got to go to the Robinsons’. They’ve lost nine today.
CUSTOMER: Well, when’s your next round?
CART MASTER: Thursday.
DEAD PERSON: I think I’ll go for a walk.

Anti-euthanasia campaigner and author Wesley Smith told Cybercast News Service it was important Burke had taken the case to court because “it is now clear that a patient who can communicate desires cannot have food and water withdrawn.

“That is a line in the sand that is helpful.”

However, he added, the judgment had “cast aside” those who were mentally incompetent or unable to communicate their wishes — “those who bioethicists call non-persons because of incompetence or incommunicability.

“I believe that the judgment clearly implies that the lives of the competent are worth more than the lives of the incompetent since doctors can decide to end life-sustaining medical care, including ANH,” said Smith, a senior fellow at the Discovery Institute and author of Culture of Death: The Assault on Medical Ethics in America.

Burke was quoted as saying in reaction to the ruling that it held “no good news at all” for people who shared his concerns.

In the light of public health service cuts and underfunding, Burke said he was worried about “the decisions that will have to be made” by doctors in the future.

“I have come to realize that there are quite a few people who feel the same way I do,” the Yorkshire Post quoted him as saying. “Not everyone wants to be put down. Not everyone wants their life to be ended prematurely.”

CUSTOMER: You’re not fooling anyone, you know. Look. Isn’t there something you can do?
DEAD PERSON: [singing] I feel happy. I feel happy.
[Cart Master hits him in the head.]

Responding to the court’s ruling, the GMC said it should reassure patients.

The council’s guidelines made it clear “that patients should never be discriminated against on the grounds of disability,” said GMC President Prof. Graeme Catto in a statement.

“We have always said that causing patients to die from starvation and dehydration is absolutely unacceptable practice and unlawful.”

A professor of palliative medicine at Cardiff University, Baroness Ilora Finlay, supported the court ruling. “Stopping futile interventions allows natural death to occur peacefully,” she argued in a British daily newspaper. “This is not euthanasia by the back door.”

But the Disability Rights Commission (DRC) took a different view.

The commission was one of several campaigners, including right-to-life activists and patients’ groups, which had strongly supported Munby’s earlier ruling.

DRC Chairman Bert Massie expressed the group’s dismay at the Appeal Court decision, saying it did nothing to dispel the fears of many disabled people that “some doctors make negative, stereotypical assumptions about their quality of life.”

It had also “totally ignored” the rights of those who were unable to express their wishes, he added.

CUSTOMER: Ah, thanks very much.
CART MASTER: Not at all. See you on Thursday.

The Night Writer’s vote for the funniest line: “Ultimately, the court said, a patient cannot demand treatment the doctor considers to be ‘adverse to the patient’s clinical needs.'” You mean, such as, “Please don’t starve me to death?”

See also Suing to Stay on Life Support.

(Monty Python and the Holy Grail excerpt available here.)

12 thoughts on “I don’t want to go on the cart

  1. Those of us who are pro-life and have warned about this kind of consequence stemming from our utilitarian culture (i.e. the kind of thinking that leads to easy access to abortion and legalized euthanasia) are routinely told such “slippery slope” arguments are a logical fallacy. Therefore please ignore this new development. It’s logically impossible.

    The most vulnerable members of our society will continue to be well… taken care of (cue sinister music)… as we’ve been assured.

  2. I simply LOVE it that the health care reform fear-mongers are resorting to using Monty-Python sketches to promote their anti-Obama agenda. Keep it coming, I haven’t laughed so hard in days!

  3. Anti-Obama? I know, Rick, that you were laughing so hard that the tears in your eyes made it difficult to see that this post was originally written in 2005 … well before Pres. Obama came to office. This may also have affected your comprehension, since the news story at the heart of the post described an actual case in Great Britain where the appeals courts and the British General Medical Council held that British doctors could withhold food and water from a man losing his ability to communicate, despite his stated wishes that he not be allowed to starve to death.

    Or perhaps you just assumed that this story was a myth or an outrageous lie? You see, we don’t have to make up scary scenarios about a proposed, untried healthcare concept; there’s plenty of evidence out there already that government rationing of early-life and end-of-life care is implicit in, and a natural outcome of, socialized medicine.

  4. You should read David Icke’s books, he and you would likely agree on a great many things.
    Referring to something government based as a “natural outcome”, when in fact it would be a “man-made” outcome, is mixing metaphors well past the point of humor or absurdity.

    Just because you know how to insert bold type into an article doesn’t make it any more believable that we will soon be living in a “Logan’s Run” society.

    Tell the lizards in the parallel dimension of the matrix that I said “Hi!”

  5. I’ve never heard of David Ickes but I have read Alfred Jay Nock, Adam Smith, George Orwell, Thomas Jefferson and, oh yeah, PJ O’Rourke who wrote, “If you think healthcare is expensive now, just wait until it is free.” Neither the current U.S. model, or the “universal/single-payer/socialized/unicorn-coalition/whatever-it’s-called-this-year” model is economically sustainable. This latest so-called reform does not solve anything, it will only pancake the whole system, including itself.

    The core of the issue isn’t really healthcare, or economics, however. They are merely the latest front in the age-old struggle for individual liberty against the just-as-human desire for a few to control the many under the guise of “helping”. Jefferson often noted that liberty decreases as government increases, but I don’t need historical references to great men; simple folk wisdom is sufficient: “He who pays the piper calls the tune.” When the government gets ultimate power to decide who gets what – whether healthcare or food or whatever – it gets the power to decide which individuals or groups will live and which will die. It happens all the time and is still happening all around the world today. You may be comfortable that the present, oh-so-transparent administration would never abuse it’s authority, but what about the next one (or the last one)? Does not the teensiest red flag start to wave somewhere in your mind as you ponder this?

    You know, Thomas Jefferson also said, “Errors of opinion may be tolerated where reason is left free to combat it.” The current national debate seems to be focused on rail-roading reason before it can even get out of bed. But for you and me, Rick, let us reason together. I’ve outlined what I believe to be a moral foundation for resisting this power-grab; now you tell me why you think it is such a good idea and why everyone should just fall in line. What are the principles dear to you, the truths you hold to be self-evident, or do you just have a pocketful of snark? If it’s only the latter I fear this conversation will merely be another classic Monty Python sketch: “The Argument Clinic.”

  6. Pingback: Come, let us reason together | thenightwriterblog.com

  7. Perhaps I’m missing something, where exactly in this discussion do you outline what you “believe to be a moral foundation for resisting this power-grab”. I see a lot of unfounded accusations and conjecture.

    This article is based on a British court case from 2005, I saw nothing in the article concerning “Obama-Care”, yet that seems to be the direction the reader is supposed to follow.

    On the one hand you say you don’t need to quote “historical references to great men”, then repeatedly do so anyway, and to consider Thomas Jefferson as “great”?
    A slave owner who repeatedly had extramarital affairs with his slaves? He has more illegitimate offspring than legitimate. There are some family values for you. Not really my opinion of a “great man”. A great politician perhaps.

    George Orwell was a very good author. The ideas he presented were not new, he did not invent the dystopian novel, he just presented it in a different light. As for 1984, he was only of by about 20 years. In 2004 The government took the concept of “thinkspeak” and dis-information to new heights.

    The power grab you speak of was most recently greatly enhanced by the Bush/Cheney Administration, as a way of silencing dissent over the Iraq war. Now that the Democrats are in control of the oval office,and congress, suddenly the Republicans seem to think that the office of the president has TOO much power.

    Don’t you remember “If you are not with us,
    you are against us.” ? Or even before the 2000 election, on finding out that there was a website mocking him, George W. Bush saying” I think there ought to be limits on free speech.”

    To quote a founding father, “Those who would surrender liberty for security deserve neither.”

    I too am against the government taking away basic liberties, but the previous administration did that already. Suspending habeus corpus, torturing prisoners. Re-defining POWs as “enemy combatants” when the Geneva convention got in the way of torture. Ignoring the bill of rights when it got in the way of defending an unpopular war.
    Making the government control ever greater than it was through the re-organization of existing government offices under the umbrella of the “Department of Homeland Security”.

    “Outing” a CIA operative when her husband uncovered evidence that the administration claims of Iraq buying uranium from Africa were manufactured. Thereby risking the lives of dozens of other CIA operatives, and undermining the so called “war on terror”.

    Need I go on?

    So far the current administration has done nothing more than to suggest a new insurance system is needed. Not a new health care system. A new insurance system were fewer people are left out. There are no “death squads”. They are not going to kill off the old and weak or deny them health care.

    The biggest problem seems to be uninformed people crying “foul” before the game has even started. The Obama-care “bill” that you refer to in your introduction, does not exist. There are several different “plans” that are being promoted, none of them involve euthanasia.

    I hold only one truth to be “self-evident” “I think therefore I am.” Everything else is based upon that.

    I believe that “Without deviation from the norm, progress is not possible.”
    The norm at the moment, is that most people are afraid of change of any kind. Some people will use that fear to promote their own agenda. I feel we need to deviate from that “norm” and openly communicate about the real issues at hand.

    I hope you don’t consider this reply a “pocketful of snark”.

    I also appreciate the chance to offer a dissenting opinion on YOUR blog.
    Peace.

  8. Rick,

    To begin at the beginning of your last comment: Yes, you did miss something. The point I’ve been making all along is that government is antithetical to individual liberty and that the greater the size of a government, the greater the threat to individual liberty. Allowing government (note, I’m not saying Democrats or Republicans) to control anything – even with the best of intentions – will result in less liberty and more unintended consequences. This has been demonstrated over and over again through history and especially in the last 60 years. This is fundamental in the way I look at anything, but my view isn’t some curious or radical philosophy I picked up from talk radio; this is a common theme in the works of the men I cited earlier, of the Enlightenment, and the reason the Bill of Rights was created (10 amendments that limit the rights of the government, not the rights of individuals, though you’d be hard-pressed to find many today who understand that distinction). Government inevitably wants to get bigger, whether it’s an evil conspiracy or just plain job security, it always happens. Individuals are always at risk of losing – or willingly ceding – their liberty to it’s bureaucratic maw. The only defense is vigilance and resistance; as you so aptly pointed out, “Those who would surrender liberty for security deserve neither.”

    This reasoning alone, applied to the healthcare debate, should be enough to make one automatically distrustful of any government’s motives and certainly of it’s capacity to do harm. Just on theory, it ought to raise a warning flag. In reality, as I said earlier, a government run health system (just as in anything the government runs) will be inefficient, wasteful and more expensive than a free market alternative and when there isn’t enough money to provide everything then care is going to be rationed, and the government will decide who is expendable. Sure, it won’t officially euthanize anyone, but when you deny certain types of care as being “inefficient” for people too young or too old to be of use to the state, you limit the choices and quality of life of those people. That’s what they do in Britain, of which the article I cited is only one example, and I could show you more of the same thing being done with disabled infants. This isn’t myth or exaggeration, it happens and it’s documented. They don’t call it a “Death Squad”, but what is the effect of the their General Medical Council (cited and quoted in the article) issuing guidelines on who should and shouldn’t receive food and water?

    As to my citing Thomas Jefferson, and your dismissal of him (and accordingly his ideas) as unworthy because he was a slave-owner and slave-diddler, I guess you’ve got me there and I’ve no choice but to similarly dismiss the Declaration of Independence.

    You also say, “I too am against the government taking away basic liberties, but the previous administration did that already.” (there I go again, showing off my mad html skillz). This is a non-sequitur; if you are against the government taking away liberties how do you pass it off by saying the previous administration did it too (or first)? Nowhere, by the way, in my original post or these comments, will you find any defense of the Bush administration, and my introductory reference to “Obama-care” was merely a shorthand description of the current version of a long-standing concept. This is an eternal struggle that transcends administrations, and one of the biggest reasons to keep a check on government power is because you never know how future administrations will use or abuse it.

    As to your statement that no healthcare bill exists, you are clearly wrong. The bill is H.R. 3200 and it’s some 20-times the lenght of the U.S. Constitution, and Sections 122 through 124 of the bill describe provisions that directly threaten the viability of private health insurance (though, perhaps, without outlawing it, as the Canadians did).

    I will say your last comment was more substantive and less snarky than your initial ones, and I appreciate that. Dissenting or differing opinions are welcome here and will be respected to the degree that they try to make points and articulate an argument (even an unpopular one) rather than just tossing off one-liners, tired talking points or personal, ad-hominem attacks (not saying that describes your work, just the things I don’t like and have little patience for – from any political perspective). Come back any time.

  9. Pingback: I STILL don’t want to go on the cart | thenightwriterblog.com

  10. Sounds like Ratio Rick has someone he’d like to get into the cart right away.

    (cartoon bubble above RR’s pointy head) “hmmmm, if dad’s gone, I can move upstairs and put mom in the basement!”(/bubble)

  11. “So far the current administration has done nothing more than to suggest a new insurance system is needed. Not a new health care system.”

    That’s only because Pelosi smelled burning tar. The idea is to get us on the stove over a low flame.

    “A new insurance system were fewer people are left out.”

    An ill-considered, unconstitutional mandate from which hundreds of companies have already received waivers…more are left out every day.

    “There are no “death squads”. They are not going to kill off the old and weak or deny them health care.”

    Let’s try this; “Social security is solvent, no one will get left out.” Sound familiar? Frickin’ moonbats are evidently unaware that not everyone got stuck in a public school.

    “The biggest problem seems to be uninformed people crying “foul” before the game has even started.”

    No, the biggest problem is foul people spreading disinformation to get their neighbors into the cart.

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