Caring for the Critically Ill — Not a Job Description for Politicians

Posted on | May 25, 2007 | Comments Off on Caring for the Critically Ill — Not a Job Description for Politicians

Dr. Chris Johnson, former director of Mayo Clinic’s pediatric ICU, has written an important book. It was published by New Horizon Press and is titled “Your Critically Ill Child: Life and Death Choices Parents Must Face.” Chris makes the case for personalizing care, informed mutual decision making and trusting America’s families to make the right choices at difficult times.

In chapter 6, Knowing When to Quit, Chris reflects on the Schiavo case and has this to say, “What can we learn from all of this? What does Terry Schiavo’s and Shelly’s (a patient of Dr. Johnson’s) story mean to families faced with similar critical decisions? It is my opinion that our society appears to be ever more willing to intervene in decisions that are the proper realm of patients and their families. This is a very disturbing trend, because legislation is an extremely blunt instrument for deciding ethical questions.”

Reflecting on the role of the courts, he says: “…..in my career I have encountered the court system several times over cases like Schiavo’s, times when physicians and families, or factions of families, could not agree…. I believe, in all of these cases, the courts found their way to well-reasoned judgments.”

And on local control: “….each case is unique in its own way. Circumstances always differ from patient to patient and family to family. The right to decide issues of life and death rests with parents and their families, and no one else. What is actually astonishing is how rarely the courts are asked to intervene in these questions. Virtually all families …. rise magnificently to the challenge to make thoughtful, appropriate, and ethical decisions about their loved ones. America must trust families to continue to do this.”

What Chris says is the truth, and the truth resonates with almost all physicians. That’s why the politicization of the Schiavo case, and especially the remote analysis from Washington, rang a sour note with the medical community. As Chris so well outlines in this book, caring for the critically ill person is complicated and needs to remain both personal and local.