I've recently come across two very different medical policies with one thing in common: they grant patients an oddly asymmetric autonomy, guaranteeing them only the right to cause more death. If patients instead make the choice which favours life, their doctors are free to override it. Really. I don't know what the world's coming to.
1) via Right Reason (N.B. I'm unsure of the partisan source's reliability):
According to Smith, the bioethics committee at St. Luke's is applying an emerging approach to treatment decisions called "futile-care theory." He summarizes:
"In order to honor personal autonomy, if a patient refuses life-sustaining treatment, that wish is sacrosanct. But if a patient signed an advance medical directive instructing care to continue -- indeed, even if the patient can communicate that he or she wants life-sustaining treatment -- it can be withheld anyway if the doctors and/or the ethics committee believes that the quality of the patient's life renders it not worth living."
Assuming the story is accurate: The only possible justification I can think of for this would be if it was an issue of limited resources for publicly-funded healthcare, resources that could be better spent helping others in need. (Though presumably a better option would be to boost health funding enough that all those in dire need can be adequately cared for.) But that would have nothing to do with judgments of whether or not the patient's life was "worth living". The question would rather be whether the limited health resources could do more good elsewhere. (The answer might be "yes" even if this dying patient has a life still worth living.) In any case, it's incredible that external authorities could override an individual's own judgment of whether their life is worth living. Unbelievable. (They clearly need to be taught a thing or two about subjectivist theories of welfare!)
2) via No Right Turn: doctors are duty-bound to respect the wishes only of those who don't wish to be organ donors. It seems that doctors are perfectly entitled to let perfectly good organs go to waste, against the express wishes of the deceased, if for any reason they do not wish to harvest them. (It's hard to think why they'd want to cause needless waste here, but it's the asymmetry of principle that I find striking. For the more practically minded: apparently one common reason is "respect" for the religious beliefs of grieving relatives. Never mind the person whose life those organs could have saved!)
And I find it kind of funny
I find it kind of sad
The dreams in which I'm dying
Are the best I've ever had
I find it hard to tell you
'Cos I find it hard to take
When people run in circles
It's a very, very...