Arnold Kling Gets Cold Feet Over Bioethics

In this week's The New Republic, bioethicist Ezekiel Emanuel commented on provinding experiemental treatments to cancer patients (behind a subscription wall):

Getting Virginia another experimental drug was not going to stop her breast cancer from growing and eventually killing her. I gently explained to her that investing all her energy chasing after another unproven drug was not going to help her and her family. Virginia was disappointed and refused to consider hospice, because she saw it as giving up. Holding her hand, I talked to her about spending time with her husband and daughters and making a videotape for her future grandchildren. We also discussed getting visiting nurses to come to her house. I saw her once more in my office. She was more accepting and found at least some of the activities meaningful. Because of her failing liver, less than three months later, she lapsed into a coma and died with her family present.

In "Is Bioethics an Oxymoron?," Arnold Kling comments at Cato@Liberty:

If I decide that I want to fight rather than go down graciously with a terminal illness, I will look for a doctor who is not a bioethicist. I found this article so chilling that it leaves me nearly speechless.

Where I disagree with Dr. Kling is that I think that non-treatment can be ethical, even if the patient wants "everything done." I would say most of the questions in bioethics deal with death and dying. The simple fact is everyone dies (Keynes was right about something, at least until we become post-human). Another simple fact is the vast majority of people want to live and not die.

The ethical question is: what constitutes a good death? This is probably a question that needs to be answered individually. Personally, I don’t want a long, drawn out death filled with pain and suffering. For cancer patients, there’s always another experimental treatment to generate a remote hope. Furthermore, both the patient and their family are understandably distressed, which is not conducive to rational decision making. Unfortunately, sometimes a clinical ethicist needs to come in and suggest that one’s last days may be better spent with one’s family and friends preparing for death, rather than incapacitated with toxic chemotherapy.