Saturday, April 23, 2011

Should we have rights?

I recently watched an episode of the television show House in which Martha Masters, a medical student, was overseeing the case of a young girl with cancer. The girl was planning on sailing around the world to break a record when she was diagnosed with cancer in her arm. The treatment was amputation, a treatment she was willing to undergo after her sail. And there was a good chance she would die of the cancer long before she finished going around the world.

Masters found it unacceptable that the girl was willing to risk her life for a record, and that the girl's parents were willing to let her take that risk. The medical student gave the patient a drug that caused a cardiac arrest, told the parents the crisis was caused by the cancer, and handed them a consent form to allow her to cut off their daughter's arm. Problem solved.

Well, not really. The problem is that in the United States, patients have the right to make their own medical decisions, whether or not they are smart decisions. Even a minor can express their wishes, and if their parents or guardian is willing to abide by that decision, a doctor has no right to override the wishes of the patient. Legally, all a doctor can do is give the patient the information. Whatever the patient decides to do with the information, the doctor must abide by it, even if the patient should decide not to have any treatment at all. Even if that means the patient will die.

It was an interesting episode, but what was really fascinating was the reaction at the Internet Movie Data Base (imdb.com). Many people took it very personally that the girl was willing to risk dying for a record. There was a great deal of invective towards posters who pointed out that legally the girl was entitled to live her own life and make up her own mind. There was also a great deal of praise for Masters for ignoring the wishes of the patient, the refusal of consent of the parents, and the laws governing the medical profession. Without really thinking about the implications, people posted comments about hoping their doctor would save their life even if said doctor had to violate their rights to do so.

Are these people right? Should we even have rights when it comes to medical decisions? After all, doctors go to medical school for many years and then train for the rest of their lives. They are the ones who are qualified to make the right decisions. The average person doesn't have much medical knowledge, and we all know people who take such poor care of their health it's a wonder they are still alive. Isn't it better to let the doctor be in charge, for their own good?

Maybe it would be, if it wasn't for a little thing called freedom. Freedom to choose is also the freedom to choose wrongly. And I guarantee that whoever you are, whatever your position in life, you're doing something at least once a day that someone, somewhere, would find fault with and prevent you from doing if they could. Overweight people who don't exercise, smokers, people who don't use sunscreen, people who use antibiotics for viruses-the list of poor health decisions is rampant all over America. And the fact is that we like it that way. We like being able to eat what we want and do what we want and avoid what we don't want. We like being able to exercise autonomy over our own bodies, and we like being able to ignore the doctor if we are told to do something we don't want to do.

Is this a good thing? From a completely logical standpoint, looking at how our behavior affects society and costs society, no. From the standpoint of our human rights, the answer has to be yes. As John Milton said, "Who overcomes by force hath overcome but half his foe." It's not like forcing people into correct decisions will change their minds or hearts. Forcing someone to do something is just changing behavior, and that behavior can only be changed permanently if the person wishes to do so. It's terribly frustrating to see people make bad choices that impact their health and cost society millions and millions of dollars every year. It's also reassuring that in the United States, people have the freedom to make their own choices. Freedom to choose is also the freedom to choose rightly, and when we do so, because that is what we wish to do, we strengthen ourselves and we strengthen our country. Freedom is never cheap or easy. That's what makes it worth having.


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