The phrase “death panel” does not actually occur in any of the proposed “health care reform” bills. MoveOn.org has seized on Sarah Palin’s characterization of the outcome of “reform” in its mass email piece entitled “Top Five Health Care Reform Lies: and How to Fight Back”:
“Lie #1: President Obama wants to euthanize your grandma!!!”
When asked about the end-of-life counseling provision at an AARP-sponsored “tele-town hall,” Obama grinned and told the woman called “Mary”: “I guarantee you, first of all we just don’t have enough government workers to talk to everybody to find out how they want to die” (Judi McLeod, Canada Free Press 8/13/09).
This argument is a straw man.
In fact, neither the President nor cadres of government workers would be doing the job personally, and euthanasia is not being discussed. Rather, the bills “incentivize” doctors to “counsel” patients about “options”—which must include orders to withhold life-sustaining “treatment,” such as food and water.
While signing a directive to withhold treatment or food and water, or to implement a “do not resuscitate” order, may be voluntary, suggestible patients may bow to white-coated authority, especially when the directive is presented to them to sign immediately. Vulnerable patients may be especially susceptible to guilt-provoking scenarios, such as being a burden on their families.
The counseling provision has been removed from one of the Senate bills, but many believe the enabling legislation for treatment denial is already law, in the Stimulus Package, as comparative effectiveness research. While proponents denied that there was any intention to turn this into cost-effectiveness research, an amendment to codify that reassurance into law was defeated. This “research” program is supposed to collect information on every medical visit by every patient for a national electronic database.
This is the infrastructure for a program like Britain’s NICE (National Institute for Clinical Excellence), which determines the dollar value of a Quality Adjusted Life Year (QALY). NICE allows payment for treatments that cost less than that, and disallows treatments that cost more.
Doctors who want to violate the “voluntary guidelines” will likely have to appeal—to a body that is not called a “death panel” (Greg Scandlen, American Spectator 8/13/09).
What are the beliefs and principles of the leading reformers? Obama himself has said, “Maybe you’re better off not having the surgery but taking the painkiller.”
As Betsy McCaughey points out, prominent Administration advisor Ezekiel Emanuel, M.D., “believes that ‘communitarianism’ should guide care. He says that medical care should be reserved for the non-disabled, not given to those ‘who are irreversibly prevented from being or becoming participating citizens…. An obvious example is not guaranteeing health services to patients with dementia’ (Hastings Center Report, November/December 1996)” (NY Post 7/24/09).
More recently, Emanuel and others write that they “recommend an alternate system, the ‘complete lives system,’ which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, saves the most lives, lottery, and instrumental value principles” (Lancet 2009;273:423-431).
This system “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.”
Obama’s regulatory czar Cass Sunstein, who will play a major role in defining government’s role in controlling medical care, prefers the QALY formula (Joseph Ashby, American Thinker 8/15/09).
Seniors are worried. Having lost about 60,000 members, AARP is back-pedaling on its endorsement of the reform push (Wall St J 8/21/09).
It’s not just seniors who are worried. There are also the 10 million American cancer patients whose access to expensive treatments may be cut off, as it routinely is in Britain. In addition, progress in treatments may stall because of the likelihood that new technology can never repay the cost of development (Wall St J 7/31/09).
The highly touted Oregon health plan already denies payment for advanced chemotherapy, but offers to buy physician-assisted suicide instead.
Then there’s the “Death Book for Veterans,” entitled Your Life, Your Choices. The primary author is Robert Pearlman, who in 1996 advocated for physician-assisted suicide before the U.S. Supreme Court in Vacco v. Quill, and is known to support rationing of medical care. The 52-page book presents choices in a way that steers users to predetermined conclusions, like a political “push poll.” Withdrawn from the VA by the Bush White House, the book has been resuscitated by the Obama Administration. The only organization listed in the updated version as a resource on advance directives is Compassion and Choices (formerly the Hemlock Society). A July 2009 directive instructs VA primary physicians to raise advance planning issues, using this book, with all patients, not just the aged or debilitated (Jim Towey, Wall St J ).
An angry disabled Marine veteran shared his views at a recent town hall with Congressman Brian Baird.
Hospice Patients Alliance, led by Ron Panzer, is concerned that U.S. federal and state government are already trying to balance budgets by hastening deaths, without raising the issue of explicit euthanasia. In the UK, where euthanasia is illegal, continuous deep sedation (CDS) may account for as many as one in six deaths (BBC News 8/12/09).
Palin quotes NY State Senator Ruben Diaz, a Democrat, chairman of the Aging Committee: “Section 1233 of [H.R.] 3200 puts our senior citizens on a slippery slope and may diminish respect for the inherent dignity of each of their lives” (Hawaii Free Press 8/12/09).
To the consternation of the Obama Administration and congressional Democrats, many Americans have shown up at tea parties and town halls with symbols warning about where that slippery slope has led before.
Daniel Greenfield observes the similarity in thoughts expressed by Dr. Ezekiel Emanuel and Dr. Hermann Pfannmüller, who stood trial at Nuremberg for his Starvation Hospitals for those he deemed unfit:
“The idea is unbearable to me that the best, the flower of our youth must lose its life at the front in order that feebleminded and irresponsible asocial elements can have a secure existence in the asylum.”
Pfannmüller preferred the “simpler, more natural” method of starvation to poisons or injections, which might supply “inflammatory material” for the foreign press.
“[A]t the heart of the difference between socialized medicine and free market health care,” writes Greenfield, is that “in the free market no one gets to class an entire category of people as “Life Unworthy of Life” (Canada Free Press 7/28/09).
Greenfield notes that it takes time for the consequences of changing from an individual to a collective morality to become manifest. “Most systems don’t turn monstrous over the weekend. Even Nazi Germany took nearly a decade to follow through on to the logical conclusion….” (Canada Free Press 8/11/09).
General Dwight D. Eisenhower ordered extensive photographs of those consequences to be taken, predicting that in 60 years some would try to deny that the events ever happened.
- “Futilitarianism,” AAPS News, July 2005.
- “Dependency and Death,” AAPS News, June 2005.
- “Why Terri Schiavo Had to Die,” AAPS News, May 2005.
- “The Holocaust Memorial, Ayn Rand, and Politics in Pre-Revolutionary New York: Lessons for Today,” by Joseph M. Scherzer, M.D., presented at AAPS annual meeting in San Antonio, Texas, Oct 8, 1993