Posted on 06/16/2012 1:56:35 PM PDT by wagglebee
The Medical Establishment continues to try and misdirect the conversation on the pending threat of “death panels” under Obamacare. They pretend it is about “end of life discussions.” But even though Sarah Palin mistakenly made that allusion when she first coined the term, she quickly corrected her mistake–as we noted here.
“Death panels” really refer to the threat of health care rationing and centralized cost/benefit bureaucracies deciding that efficacious treatments will not be covered based on quality of life invidious discrimination–as occurs already in the UK, Canada, and Oregon’s Medicaid rationing law.
But they keep pretending. Latest example: In the Annals of Internal Medicine, a physician named Mark Vierra recounts an experience from his practice in which a woman decided to take her dying husband home to die rather than keep him maintained on machines in the ICU. He concludes with an allusion to death panels. From “Death Panels” (no link, 6 March 2012 )
Recently, we have been warned that government “death panels” would knock us off. The provision in the new health care legislation, which said that private, end-oflife discussions between a patient and his or her physician would be reimbursable every 5 years, somehow became a sinister governmental strategy to kill us quickly and save resources. It disappeared from the President’s health care legislation, was quietly added back as a Medicare provision, but disappeared again when the new Medicare guidelines came out. Can this sensible, thoughtful proposal really be so objectionable?
“I want to take him home.” I am so grateful to this man’s brave wife, who knew exactly what her husband would have wanted. She didn’t need me to tell her what kind of man her husband was, to discuss with her the meaning of life or the nuances of medical futility. What she needed was someone to help her see what was about to happen in the world of medicine—a world that was foreign to her but one in which I travel every day. These conversations are difficult for me. They are so much harder than explaining the rationale for an operation, the side effects, or the risks; I don’t feel that I am very good at them. But every one of my patients is going to die one day. Like it or not, I should have these conversations earlier, more often, and more comfortably. If that makes me part of a death panel, well, I suppose I can live with that.
Of course, that doesn’t make Vierra part of a death panel. It is part of the job.
But rather than playing hide the ball by discussing a non death panel issue, I wish Vierra had addressed the real threat of death panels, e.g., a similar situation in which a different wife wants to keep her husband in the hospital to extend his life–and government bureaucrats and cost/benefit schedules tell her she can’t. Or, they refuse to cover chemotherapy because it will only likely extend life for several months. and the Obamacarians decided that benefit wasn’t worth the price. Or, how doctors/bioethicists are already refusing wanted life-extending treatment based on Futile Care Theory protocols.
Those are the very real threats about which the death panel polemic properly applies. Pretending otherwise won’t make the issue go away.
The public needs to be aware just who grave the threat of death panels really is.
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They should just call them Racial Hygiene Panels and be done with it. Then they can move on to having Jews were a yellow star and Christians wear a yellow cross.
As icing on the cake, the queers could have snappy black uniforms and the authority to enforce racial purity laws. That way the facts would be in the open so that even the idiots still claiming to be “independent” voters would finally have to take sides.
Applying a strict “quality adjusted remaining years” cost/benefit ratio is perhaps a trickier equation than the so-called “ethicists” are able to handle. If the bills are being paid by a third party, they are going to look at the afflicted individual purely as, “How do we come out on this on an actuarial basis?”
Suppose that treatment is going to cost, say, a million dollars. But the person, once treated, and on some sort of rehabilitation program, will only live an additional five years or so, as compared to merely palliative treatment and domiciliary care, which can be provided for maybe, a tenth of that cost. To that faceless panel, the decision is clear.
Now, the “what if”. What if, by some combination of a misdiagnosis of the condition and an unusually strong constitution, the person was NOT all that certain to die in the five years, and lives on to gain a whole new phase of life and unusual productivity? Is the million spent then so much in vain? Or would taking the “cheap” way have been an injustice that could never have been rectified? That is what keeps juries employed and legal experts wealthy.
The very concept of “wrongful death” would be subject to redefinition.
They already exist. If you have any form of insurance, your health care depends upon the agreement of some box checker at the office not your own doc.
It won’t be better under O’s wet dream either. Just don’t kid yourself that somehow they don’t exist already
It should be my decision what treatment I get, Not some panel of affirmative action workers, or some Affirmative action worker who happens to be on the computer that day.
Unless you pay the full price yourself some one else will be ‘helping’ you with decisions
Am I missing something here? Obviously, the so called educated doctors can't figure this out for themselves.
Is it any different than an insurance company deciding based on costs and limited resources? Don't know. But, do not lie to the American people and tell us that there won't be rationing or a panel of bureaucrats deciding the fates of the elderly and sick.
Exactly. And don’t let them lie to you. There will be “death panels” or whatever you want to call them.
It is surprising how much discretion remains with the family and doctors in spite of the current system.
There is probably a limit, though.
The majority of the US health care professionals care deeply for the patient’s welfare and wants. They work really really hard to be sure that the patient is well cared for. Sometimes that means finding creative ways to make that happen
Ya. It seems that if the patient insists, a lot of times the patient gets what they want with the help of the doctor (of course).
Don’t know about more expensive treatments like organ transplants.
Also, many patients and patient families tend to self limit.
The question should always be what is best for the patient? That means quality of life as well as quantity. Sometimes the best care is that which is palliative (comfort care).
Agreed.
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