Mario Cuomo and the Fight for Patients’ Rights

New York State Task Force on Life and the Law

An iPub Forum, “Did You Know?” Series, Part Two

by James Rudin

My eighteen Task Force years of service revealed that making realistic and sensible medical decisions is rapidly becoming the single most important aspect of a clergyperson’s life. Those decisions are the most difficult and painful questions rabbis, priests, pastors, or imams face at the bedside of a dying individual.

And what a surprise! It’s not abstract theological or metaphysical queries. Rather, most questions, usually asked in a hospital room, go like this. “My beloved family member is gravely ill. The doctors are recommending some extraordinary and complex medical treatments. I am confused, and I am being asked to make a decision. As my spiritual leader, please tell me, what should I do?”

 My years on the Task Force provided a unique vantage point to witness the rapid changes in medical technology, but I also became aware of a larger issue that our religious leaders have not adequately confronted: bioethical decisions about the allocation of vital but limited medical resources including health care professionals, mechanical devices, and organ replacements.

For decades, most Americans falsely believed that every needed medical resource would always be available to them 24 hours a day, seven days a week, no matter a person’s age, gender, race, socio-economic class, or place of residency.

But that was a mistaken belief. Medical resources are always finite, and today they are becoming scarcer and increasingly expensive. The growing shortage of physicians, nurses, and other healthcare providers and the escalating costs of prescription drugs are additional signs of a health system at risk.

And tragically, the horrific COVID-19 pandemic clearly revealed that both human and medical facilities are quite limited and can collapse under the strain of a global deadly virus.

Despite these obvious and ominous signs, most of the nation’s spiritual leaders and seminary faculties have not addressed the key bioethical questions that require immediate attention.

For example, who is more entitled to the finite and often shrinking medical facilities? Children under 3 years of age or the elderly? What steps, if any, can be taken to deliver necessary quality health care to America’s rural communities?

But one thing is certain: medical science and technology will move forward with or without the religious community. Major decisions about health care in the U.S., including the overwhelming question of withdrawing and withholding life support systems from desperately ill or comatose patients, will be made with or without the “benefit of clergy.”

If the best thinkers within our faith communities do not address these issues in a thoughtful and informed way, others will decide for us, and that would be an abdication of religious leadership. If that happens, rabbis, priests, pastors, and imams will have no one to blame but themselves, and worst of all, desperately ill patients and their troubled families will be the losers.

In a painful twist of personal history, Dr. David Axelrod, the Massachusetts-born son of an Orthodox rabbi, suffered a debilitating stroke at age 56. He was one of the most competent, dedicated public servants I have ever encountered, and, alas, poor David died three years later. He was only 59 years old.

I mourned when Mario Cuomo died in early 2015. Lost in the extensive media coverage of his death was no mention of one of the former governor’s most enduring achievements: the New York State biomedical Task Force on Life and the Law.

During his first term as governor, Cuomo established the Task Force because he was concerned that as developments in medical technology and science accelerated, neither society nor state government was prepared for the critical decisions required in the face of such rapid change. Cuomo’s instruction to our group was to study the new frontier of bioethics and make specific public policy recommendations for state lawmakers.

Cuomo wanted us to focus on the right of patients to make informed decisions about their medical conditions. One result of the Task Force’s efforts was to shift the center of the medical universe to the patient — something that especially pleased the three-term New York governor.

Cuomo opposed those who sought preferential treatment in waiting in line for an organ transplant. He deplored the rich and/or famous celebrities who demanded a place at the front of the organ replacement queue.

Former New York Governor Mario Cuomo addresses the crowd at the 1992 Democratic National Convention at Madison Square Garden, New York.

Cuomo will likely be remembered for many remarkable political achievements, but the enduring success of the Task Force he created in 1985 still remains one of the crown jewels of his political career and the standard by which all similar efforts in the other 49 states must ultimately be judged.

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