Citation

Phillips JB. J. Health Care Finance 2019; 45(4).

Copyright

(Copyright © 2019, Aspen Publishers)

DOI

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PMID

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Abstract

At 6'5'' and 260 pounds, Thomas D. Phillips was a big man. His athleticism earned him a football scholarship to the University of Kentucky. Like so many other Americans, his education was interrupted by World War II. Tom joined the Army Air Force with dreams of being a fighter pilot. Unfortunately, his size precluded a comfortable fit in a Grumman F6F Hellcat, and thus he was trained to pilot a B29 bomber. On his third mission over Nazi Germany, First Lieutenant Phillips' plane was shot down and he became kriegsgfangener, #5735 Kgflgd.L.W.3. Wounded during the crash, Tom sustained injuries to the lower third of his face and lip that received no medical attention during his two years of incarceration. Unfortunately, one of the only "pleasures" afforded the prisoners was German cigarettes. The combination of unhealed oral wounds and nicotine would be of immense significance in his future. After being repatriated to the United States, Tom began rebuilding his life: marrying, graduating from the University of Tennessee, beginning a career, and fathering a son. Years later, he developed cancer of the mandible secondary to his service injuries that required multiple facial surgeries. He was diagnosed with metastasis to the brain in 1964. In his final days, Tom was cared for at home with the assistance of his physician brother-in-law, an internationally renowned trauma surgeon. In those days, physicians commonly carried a "doctor's bag" complete with appropriate emergency supplies-including pain relievers. Although fully lucid, Tom endured intense and unremitting pain from the brain metastasis that necessitated morphine as needed. He died of respiratory failure at age 47, only 24 hours before his only son graduated from high school. Had Tom been at a VA or other hospital, his intense suffering would have continued unabated since the state did not recognize the right of a competent, terminally ill adult to die with dignity. Since pre-Socratic times, the benchmarks for debate regarding end-of-life decisions have been the application of natural law and the concept of maintaining self-determination. Evolving western legislative and judicial decisions have produced effects counter to these established standards. The legitimacy of any government is established by those that are governed-a concept founded in early classical antiquity, codified in the Magna Carta, and enshrined in the United States Constitution and Bill of Rights through the writings of Thomas Jefferson. These truths are self-evident. Perhaps John Stuart Mill applied the theory of justice most accurately when he wrote, "The human faculties of perception, judgment, discriminative feeling, mental activity, and even moral preference, are exercised only in making a choice. He who does anything because it is the custom, makes no choice. He gains no practice either in discerning or in desiring what is best. The mental and moral, like the muscular powers, are improved only by being used…He who lets the world, or his own portion of it, choose his plan of life for him, has no need of any other faculty than the apelike one of imitation. He who chooses his plan for himself, employs all his faculties"261. © 2019 Aspen Publishers Inc.. All rights reserved.

Language: en

Keywords

human; law; assisted suicide; dying; medical decision making; right to die; Article; human dignity; patient autonomy; Middle Ages; modern times; early modern period