In the NYT today, a doctor admits letting patients die because he judges them to be immoral. It comes in the context of new guidelines to govern the use of statins, amazing drugs that significantly reduce the risk of heart attack with only limited and tolerable side-effects.
Apparently, some doctors are concerned that the new guidelines might allow the use of statins to help the undeserving:
Dr. Paul M. Ridker, the director of the center for cardiovascular disease prevention at Brigham and Women’s Hospital, in Boston, said he worried the new guidelines could easily lead to overtreatment. An older man with a low LDL level who smokes and has moderately elevated blood pressure would qualify for a statin under the new guidelines. But what he really needs is to stop smoking and get his blood pressure under control.
What medical reasoning lies behind the determination that what this patient "really needs" is not to receive a life saving drug? Here are the medically relevant facts:
- Smoking is perhaps the most addictive activity known to man. A large percentage of people who smoke will find it physically impossible to stop, thanks to factors beyond their control. Such people had no way to know that they would fall into this category before they started smoking. They will literally die before giving up the habit, no matter who hard they try to quit, and worse, no matter how many doctor's lectures they are forced to endure.
- Blood pressure is as subject to "control" as the weather.
If a doctor were to say to a prostitute with hepatitis, "Because of your voluntary (?!?!) actions that I believe to be immoral, I am going to withhold treatment and let you die," that would be murder. So why aren't we prosecuting when the actions in question are even less voluntary?
Ignorance of the law is no excuse, but doctoral ignorance of medical facts is a legitimate legal defense to murder. Because facts 1 and 2 above are largely unknown to the medical profession, doctors aren't "knowingly" murdering their patients. Instead, they are accidentially killing them.