PARASITE:

The English Patient: Leslie Burke wants to live; the National Health Service has a second opinion. (Wesley J. Smith, 05/30/2005, Weekly Standard)

THE MOST IMPORTANT BIOETHICS LITIGATION in the world today involves a 45-year-old Englishman, Leslie Burke. He isn't asking for very much. Burke has a progressive neurological disease that may one day deprive him of the ability to swallow. If that happens, Burke wants to receive food and water through a tube. Knowing that Britain's National Health Service (NHS) rations care, Burke sued to ensure that he will not be forced to endure death by dehydration against his wishes.

Burke's lawsuit is even more important to the future of medical ethics than was the Terri Schiavo case. Schiavo was dehydrated to death--a bitter and profound injustice--because Judge George W. Greer ruled both that Terri was in a persistent vegetative state and (based on statements she allegedly made during casual conversations some 20 years ago) that she would not want to live under such circumstances. In other words, Terri Schiavo lost her life in order to safeguard her personal autonomy, though she never made the actual decision to die.

But Burke, who is fully competent, worries that his wishes will be ignored precisely because he wants food and water even if he becomes totally paralyzed. Receiving food and water when it is wanted certainly seems the least each of us should be able to expect. But, it turns out, whether Burke lives or dies by dehydration may not be up to him. According to National Health Service treatment guidelines, doctors, rather than patients or their families, have the final say about providing or withholding care.