Obama's Health Rationer-in-Chief: Hippocratic Oath Responsible for "Too Much" Medical Care
"Death Panels", anyone?
Dr. Ezekiel Emanuel, health adviser to President Barack Obama, is under scrutiny. As a bioethicist, he has written extensively about who should get medical care, who should decide, and whose life is worth saving. Dr. Emanuel is part of a school of thought that redefines a physician’s duty, insisting that it includes working for the greater good of society instead of focusing only on a patient’s needs. Many physicians find that view dangerous, and most Americans are likely to agree.(emphasis and editorial commentary added)
True reform, he argues, must include redefining doctors' ethical obligations. In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the Hippocratic Oath for the "overuse" of medical care [ED.: Why should the Hippocratic Oath be an impediment to ObamaCare? It's not like it's an impediment to euthanasia and abortion, despite its clear language: "I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion."]: "Medical school education and post graduate education emphasize thoroughness," he writes. "This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath's admonition to 'use my power to help the sick to the best of my ability and judgment' as an imperative to do everything for the patient regardless of cost or effect on others."
In numerous writings, Dr. Emanuel chastises physicians for thinking only about their own patient's needs. He describes it as an intractable problem: "Patients were to receive whatever services they needed, regardless of its cost. Reasoning based on cost has been strenuously resisted; it violated the Hippocratic Oath, was associated with rationing, and derided as putting a price on life. . . . Indeed, many physicians were willing to lie to get patients what they needed from insurance companies that were trying to hold down costs." (JAMA, May 16, 2007).
Of course, patients hope their doctors will have that single-minded devotion. But Dr. Emanuel believes doctors should serve two masters, the patient and society, and that medical students should be trained "to provide socially sustainable, cost-effective care." One sign of progress he sees: "the progression in end-of-life care mentality from 'do everything' to more palliative care shows that change in physician norms and practices is possible." (JAMA, June 18, 2008).
"You can't avoid these questions," Dr. Emanuel said in an Aug. 16 Washington Post interview. "We had a big controversy in the United States when there was a limited number of dialysis machines. In Seattle, they appointed what they called a 'God committee' [ED.: Would that be anything like a "death panel"?] to choose who should get it [ED.: And, necessarily, who doesn't get it. Sure sounds like a death panel to me.], and that committee was eventually abandoned. Society ended up paying the whole bill for dialysis instead of having people make those decisions."
Dr. Emanuel argues that to make such decisions, the focus cannot be only on the worth of the individual. [ED.: And, thus, ObamaCare as envisioned by Dr. Emanuel violates Catholic teaching.] He proposes adding the communitarian perspective to ensure that medical resources will be allocated in a way that keeps society going: "Substantively, it suggests services that promote the continuation of the polity—those that ensure healthy future generations [ED.: That sure sounds a lot like eugenics.], ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations [ED.: Sounds like they only want only the "best and brightest" in their new utopia; so let's go ahead and call it eugenics. And, besides, if liberal do "full and active participation in public deliberations" the same way they do "full and active participation in the Mass", count me as one even more opposed to ObamaCare.] — are to be socially guaranteed as basic. Covering services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic, and should not be guaranteed. [ED.: Yep. Eugenics.] An obvious example is not guaranteeing health services to patients with dementia." (Hastings Center Report, November-December, 1996) [ED.: Hmmm. Might the same reasoning be applied to those with less severe mental limitations? Those with developmental disabilities ... say ... a child with Downs, for example, who might not, therefore, be "full and active participants" in public deliberations? Which was the exact point Gov. Palin was making.]
There's no 2 ways about it: Sarah Palin was 100% correct, and the words of Obama's own health care advisor prove it.
And how about the concept of one's doctor having dual loyalties to the patient and the state? Recall Mark Steyn's comments in support of Sarah Palin's "death panel" description:
... But I'm also with Mrs. Palin on the substance. NR's editorial defines "death panel" too narrowly. What matters is the concept of a government "panel." Right now, if I want a hip replacement, it's between me and my doctor; the government does not have a seat at the table. The minute it does, my hip's needs are subordinate to national hip policy, which in turn is subordinate to macro budgetary considerations.(emphasis added)
You're accepting that the state has jurisdiction over your hip, and your knee, and your prostate and everything else. And once you accept that proposition the fellows who get to make the "ruling" are, ultimately, a death panel. Usually, they call it something nicer — literally, like Britain's National Institute for Clinical Excellence (NICE).
After my weekend column recounted the experience of a recent British visitor of mine, I received an e-mail from a gentleman in Glasgow who cannot get an x-ray for his back — because he has no sovereignty over his back. His back is merely part of the overall mass of Scottish backs, to which a government budget has been allocated, but alas one which does not run to x-rays.
Government "panels" making "rulings" over your body: Acceptance of that concept is what counts.
Previous Pro Ecclesia posts on this subject:
Andy McCarthy and Mark Stein Slap the Handwringing Girly Boys in Charge Over at National Review: Palin Was Right On the "Death Panels" [UPDATED]
Sarah Palin Right About Obama "Death Panels"
Health-Care Rationing Violates Catholic Teaching