Dr. Death and the SUV Generation

Pamela F. Hennessy
First published by the North Country Gazette

Dr. Ronald Cranford is a neurologist and medical ethicist who served for years as the assistant chief of neurology at the Hennepin County Medical Center in Minneapolis, Minnesota. Cranford has worked as a faculty associate for the Center for Bioethics at the University of Minnesota. He is also a rather controversial figure.

A profile of Cranford, published by the Center, states he has specialized in the field of clinical ethics since the early 1970s and was the panel member for the Hastings Center who formulated their “Guidelines on Termination of Treatment and Care of the Dying.”

Used in the capacity of an expert witness in a number of high-profile ‘right-to-die’ cases including Nancy Cruzan, Robert Wendland and Terri Schiavo, Cranford has stationed himself in the heart of impassioned debate. In the debate of life and death, Cranford comes determinedly down on the side of withdrawing assisted nourishment and hydration for certain types of patients.

On his resume, Dr. Ronald Cranford lists a hefty number of his published essays and articles. The list -- which includes such titles as Termination of Treatment in the Persistent Vegetative State; Use of Anencephalic Infants as Organ Donors; Consciousness: The Most Critical Moral Standard for Human Personhood; and Is Active Euthanasia Justifiable -- might leave one wondering if Cranford harbors just a bit of revulsion for the ailing or dependent patients he’s known through the years.

Wonder no more.

After listening to a recent lecture of Cranford’s titled “Terri Schiavo - The Aftermath”, I found myself positively disgusted by this representative of the medical profession and not over his interpretation of the medical aspects of the Schiavo case. I was staggered, instead, by what might amount to a slip of the tongue that illustrates where this self-stylized “Dr. Humane Death” is actually coming from.

In his reflections, Cranford asserted that -- in cases such as Terri Schiavo’s -- the needs of family members should be taken into consideration when deciding what to do with the incapacitated patient. Indeed, Cranford states “The needs of the family are as important if not more important than the patient’s.” My emphasis.

According to Cranford, more value should be placed -- in the clinical setting -- on assisting the involved family members in moving forward with their lives. He makes no mention of improving patient care or ensuring the patient’s needs are being met. Only of encouraging families to ‘move on’ because that is, after all, more important than their helpless loved one.

I take blood-boiling umbrage at the doctor’s assertions.

Cranford may be the bearer of a resume thick enough to prop up a toddler at a dinner table, but who on earth does he think he is marginalizing the importance of another person based on his own aversion to disability or illness? Suggesting that a vulnerable person’s needs are not as important as a non-ailing person’s needs is not a far amble from saying one is a person and one is not.

No one person is more important than another. The needs of the incapacitated or vulnerable patient, however, might in fact be a bit more pressing than someone whose life is not actually in peril. Cranford’s assessment suggests that he is suffering from SUV Generation mentality wherein the survival of the fittest appears to be the accepted wisdom, no matter who or what one must run over in the process.

Promoting the idea that sick or disabled people are nothing more than liabilities on and inconveniences to the rest of us would be quite shameful coming from a layperson. It is, in my opinion, downright fiendish coming from someone who follows his name with the designation ‘MD.’

I’ve got a pretty keen belief that, when Cranford completed medical school many years ago, someone along the way explained to him that his job as a physician was to promote wellness. Cranford’s priority as a medical doctor should be solving health-related problems for his patients and seeking new ways to promote the well-being of all patients. Systematizing and classifying the worthiness or ‘personhood’ of other human beings, according to his own personal philosophies, just isn’t his damn job.

To marginalize human beings in this fashion creates a ripple of bad public policy and Cranford should undoubtedly be aware of that.

Firstly, such attitudes only serve to dismantle healthcare ethics at their very core and create a hostile environment for the patient. Would you feel comfortable being at the mercy of a doctor who was measuring your fundamental value as a human being or your ‘personhood’ by the severity of your condition? Or, do you reckon you’d prefer someone who was ardently focused on promoting your well-being -- irrespective of your challenges or limitations?

Healthcare professionals can, and do, classify patients into categories according to their conditions. I.E.: Critical Care, Intensive Care and so on. But this does not give doctors or nurses the authority to pigeonhole human beings as lesser beings. Regardless of the patient’s diagnosis, prognosis or hope for a positive outcome, that patient is still a human being and Cranford’s inability to recognize that simple nugget of reality makes him something of a failure as a physician.

The other hazard in such philosophies is that they spill over into the public discourse, creating an environment where abandonment is favored over caring. Cranford himself admitted (in his lecture) that, upon finding out he suffered from a serious illness, his first thought was to how it might distress his family.

I rather doubt Cranford’s family would ever view him as a encumbrance or someone not worthy of human kindness or care. So why is he even thinking in that direction?

It’s probably because we’ve practically conditioned ourselves to believe that human beings are somehow capable of being burdens. They aren’t. They are our neighbors, brothers, sisters, friends and strangers but they are not burdens. Still, the typical American household cannot afford suitable healthcare coverage or the cost of emergency care, so it’s rather understandable that they feel as if these are the attitudes they should be embracing. I can certainly understand their anxieties.

What I cannot understand is how Dr. Ronald Cranford can endorse such dehumanization and call himself an ethicist., let alone a doctor. With some of his colleagues touting him as a hero for his views and attitudes, however, my opinions probably don’t create a nanosecond of trepidation for him.

Merriam-Webster defines a hero as someone with noble qualities who shows great courage.

Conversely, they define a bully as someone who is one habitually cruel to others who are weaker.

Which epithet do you suppose is most fitting for Dr. Death? 3-23-06

Pamela F. Hennessy is the Founder of the Partnership for Medical Ethics Reform (www.forethics.com) and volunteered as a representative of the Terri Schindler-Schiavo Foundation from 2002 to 2006. Reprinted with permission




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