Bioethics Blogs

Best Medical Chart Note in a Medical Futility Case

The following note was made by the Massachusetts General Hospital Optimum Care Committee in the medical record of Barbara Howe.  It expresses an exceptionally powerful assessment that the treatment requested by the family was inappropriate.  


 “We [the OCC] met again last night regularly (1/mo) +, as usual, received the update [of Barbara’s status]. There is now 100% unanimous agreement that this inhumane travesty has gone far enough. This is the Massachusetts General Hospital, not Auschwitz.”


“When, over 3 years ago, this, her terminal hospitalization began, she made it clear to everyone that as long as there was any possibility left to communicate to her beloved family, she wanted every standard resuscitation process employed should she have a cardiac and/or respiratory arrest.”


“She lies here today, her face fixed in a frozen grimace as though she were a woman now in constant suffering. Through the grimace leaks a constant flow of sputum; absorbed by the routinely changed washcloth placed at the dependent corner of her mouth.”


“They [the Hospital staff] have lived for two years with the appalling realization that they are under orders to resuscitate her and so guarantee that her gallant life will be wiped out by a senseless act of brutality. The administrative mandate demands that the dimension of emotion in their care be shut out, repressed, stamped on, derogated, or just plain pretended away. It is therefore not only delusional but unfair. It demands that the entire body of caregivers violate their professional oaths, the standards of medical and nursing practice, the standards of the Massachusetts General Hospital, and the standards of ethics, morality, human decency and common sense.”


The family has been allowed to dictate medical practice.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.