“Medically Futile Care” As Ritual. I Fucking Knew It. And People Are Okay With This?

I’ve been researching so-called “medically futile care” lately, or more accurately, it’s a rabbit hole I fell down while researching nursing and what nurses have to say about witnessing and participating in medically futile care, otherwise known as medicalized torture.  My own mother is a nurse and I know that she, after being a nurse for some 30 years, started to become disillusioned by Western medicine and the horrific procedures and treatments imposed on intractably and/or terminally ill and actively dying patients.  Of course, she didn’t start having a problem with it until after she had reaped the social and material rewards of being a disgusting handmaiden and middle class patriarchal enforcer for her entire adult life including subjecting her own children to medicalized torture: my own brother died from it and earlier this year she brutally criticised me for abandoning Western medicine after 2 years of conventional Crohn’s treatments that were not helping and only making me worse.  With a Western medical nurse as a mother who needs a firing squad (or torturer) amirite?

I have written here before about disillusioned Western medical doctors resisting their evil profession by leaving the field, including leaving via suicide.  Apparently there is currently a movement headed by Western medical doctors themselves to challenge abusive practices in their field including but not limited to hazing and domination rituals in medical school and medical residency; overwork, sleep deprivation and other conditions related to employment in the Western medical field; and cruel standards of care including those implicating medically futile care where doctors feel “forced” to literally torture sick, injured and otherwise vulnerable patients lest they lose their jobs or be sued for medical malpractice.  Doctors are actually feeling sorry for themselves because their jobs as patriarchal enforcers and medical torturers makes them feel bad, and while anyone who has ever worked before knows what it’s like to be coerced for money (and survival) those who literally, physically harm and torture other people in order to maintain their own standards of living will garner no sympathy from me.

The same goes for Western medical nurses who my research indicates suffer greatly from vicarious trauma and professional burnout from “having” to witness torturous medically futile care in their professions.  Examples of such care include flogging corpses which have no reasonable chance of being revived; continuing invasive so-called “life support” for those who are dead to the world and will probably never regain consciousness or if they do will be horrifically and permanently impaired; refusing to let extremely premature or terminally malformed or diseased infants die naturally, and so on.  Get a real fucking job, no matter how low it pays, is my response to all medical professionals who have a problem with physically harming and torturing people…yet continue to do it anyway because some man somewhere tells them they have to lest they lose their jobs if they want to continue to fund their own middle- to upper middle-class lifestyles.  Seriously fuck you a million times you poor, poor self-proclaimed victims of workplace abuse who continue to physically torture vulnerable people for money.  You absolute monsters.

As a chronically ill person suffering from an incurable and progressive disease that is notoriously unresponsive to conventional care, I recognized awhile ago that for me to engage with Western medicine when it has nothing to offer me in terms of pain and symptom relief or a net increase in my quality of life (net meaning overall, or a positive rather than negative score in benefit-minus-risk) would be nothing more or less than an engagement with a patriarchal ritual, and one that as a radical feminist would give me no comfort.  Because I see no objective or subjective value in participating in patriarchal rituals I have declined to use the doctors’ office as a confessional, to confess my sins of being a disabled female under capitalism and patriarchy to a patriarchal authority figure who can do absolutely nothing for me except to witness my confession and absolve me of the emotional burden of being sick in the first place, and medically noncompliant in the second.  That is literally what Western medicine is to me now — a patriarchal ritual — and I reject that on its face as a female who is deliberately denigrated and harmed (not healed) by patriarchy and patriarchal rituals by design.

Well come to find out this business about Western medicine and medically futile care in particular being a patriarchal ritual has been described by other people and wasn’t just something I and other radical feminists have made up in our heads: researchers actually admit it’s true in a medical journal article entitled “Rituals, death and the moral practice of medical futility.”  Of course, they frame the use of ritual in this context as a positive thing.  Here is the abstract of that article:

Medical futility is often defined as providing inappropriate treatments that will not improve disease prognosis, alleviate physiological symptoms, or prolong survival. This understanding of medical futility is problematic because it rests on the final outcomes of procedures that are narrow and medically defined. In this article, Walker’s “expressive-collaborative” model of morality is used to examine how certain critical care interventions that are considered futile actually have broader social functions surrounding death and dying. By examining cardiopulmonary resuscitation and life-sustaining intensive care measures as moral practices, we show how so-called futile interventions offer ritualistic benefit to patients, families, and health care providers, helping to facilitate the process of dying. This work offers a new perspective on the ethical debate concerning medical futility and provides a means to explore how the social value of treatments may be as important in determining futility as medical scientific criteria.

Oh by all means, let’s remove the expectation that medical care provide positive “final outcomes” for the one being subjected to it — the patient.  Because to ignore fail to extol the broader social function of torturing sick and dying people in a medicalized authoritative setting would be problematic, you see.  Do you see what they did there?  They are talking about social engineering and the effects on society at large of flogging corpses, equating zombification/maintaining a state of undead with “life support”, and spitting in the eye of natural law by refusing to allow congenitally unviable infants to not-survive infancy and so on.  And while the abstract does not list or detail the alleged benefits, the writers believe the social engineering effects are positive.  Sure, if the reader is one who benefits from collective trauma and trauma-based mind control among other things.  The rest of us, I suppose, are just expected to adopt the perspective of our oppressors.

These medical researchers aren’t even hiding the fact that most if not all medically futile including end-of-life care is ritualistic and does not benefit the patient.  They assert that it is not intended to and should not be intended to benefit the patient because why waste an opportunity for social engineering and propping up medical (patriarchal) authority by “facilitating the process of dying” as if natural law needs their help?  This is megalomaniacal.

The shit icing on the cake may even be that these researchers used a woman feminist’s ethical framework in order to justify using patriarchal authority as social engineering in cases of intractable illness and injury, including at the end of life.  They rely on Margaret Urban Walker’s Moral Understandings: A Feminist Study in Ethics, published in 1998 which is described here:

The central concept of Walker’s work is the development of the expressive-collaborative model of ethical discourse.  The expressive-collaborative model is a participatory model that engages people of all different kinds in a deliberative process that develops shared morality for a community.  She develops this model as an alternative to the theoretical-juridical model [which model is a top-down authoritative model that assumes a universal moral code applies and does not accept input from the community it asserts moral authority over.]

Of course, assuming Walker is actually a feminist, she is proposing an alternative to patriarchy and providing an entrance for women and feminists into ethical discussions surrounding social policy and practice that disproportionately negatively affect us.

But her work is not used here to challenge patriarchy, quite the opposite.  These prick researchers appear to use Walker’s alternative feminist ethical framework to support the use of medicalized patriarchal torture as ritual and beneficial social engineering…why?  Because men and Western medical doctors should be included in the creation of social policy and practice and to not include them would be unfair because they are part of the communities they serve?  (Have we hit peak liberal feminism yet?)  Because using the bodies of sick and dying people to literally send messages to other people is perfectly fine?  You’ve got to be fucking kidding me, considering that men in general and Western medicine in particular, as a fundamental patriarchal institution, already wrote the whole show including the foreword, the afterword, and the credits — and have used women and women’s bodies as useful objects the whole time.  The world is their stage, the rest of us only players, yet we mustn’t disallow men and patriarchal institutions their voice literal actual physical abuse because not only ethics, but because feminist ethics.  Got it.

Did I mention that I was right about medically futile care being nothing but a patriarchal ritual that can only harm women because that’s what it’s intended to do?  Yep.  I absolutely did mention it and I will again.  I have also discussed how sick women’s bodies are in fact used to send messages to other people, in the case of requiring women to accept harmful and misogynistic Western medical treatment in order to collect disability benefits, the message is comply or literally die.  Of course, I also framed Western medical treatment of untreatable, incurable and progressive disease as medically futile care which for some people is probably controversial but hardly a stretch if you just think about it a little bit.  Goddammit I hate being right all the time.