On 9/22/2012 12:18 PM, no hope or change wrote:
> On Sat, 22 Sep 2012 09:57:46 -0700, ?<?@gmail.not> wrote:
>> Seniors will fall victim to Obama death panels. Euthanasia will be as
>> common as abortion.
> There are no death panels.
You LIE, you old diabetic, life-support, government dole RV trash:
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.
The health bills being pushed through Congress put important decisions
in the hands of presidential appointees like Dr. Emanuel. They will
decide what insurance plans cover, how much leeway your doctor will
have, and what seniors get under Medicare.
Dr. Emanuel, brother of White House Chief of Staff Rahm Emanuel, has
already been appointed to two key positions: health-policy adviser at
the Office of Management and Budget and a member of the Federal Council
on Comparative Effectiveness Research. He clearly will play a role
guiding the White House’s health initiative.
Dr. Emanuel says that health reform will not be pain free, and that the
usual recommendations for cutting medical spending (often urged by the
president) are mere window dressing. As he wrote in the Feb. 27, 2008,
issue of the Journal of the American Medical Association (JAMA): "Vague
promises of savings from cutting waste, enhancing prevention and
wellness, installing electronic medical records and improving quality of
care are merely ‘lipstick’ cost control, more for show and public
relations than for true change."
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: "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,
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).
"In the next decade every country will face very hard choices about how
to allocate scarce medical resources. There is no consensus about what
substantive principles should be used to establish priorities for
allocations," he wrote in the New England Journal of Medicine, Sept. 19,
2002. Yet Dr. Emanuel writes at length about who should set the rules,
who should get care, and who should be at the back of the line.
"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’ to choose who should
get it, and that committee was eventually abandoned. Society ended up
paying the whole bill for dialysis instead of having people make those
Dr. Emanuel argues that to make such decisions, the focus cannot be only
on the worth of the individual. 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, ensure development of practical reasoning skills, and
ensure full and active participation by citizens in public
deliberations—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. An obvious example is not guaranteeing health services to
patients with dementia." (Hastings Center Report, November-December, 1996)
In the Lancet, Jan. 31, 2009, Dr. Emanuel and co-authors presented a
"complete lives system" for the allocation of very scarce resources,
such as kidneys, vaccines, dialysis machines, intensive care beds, and
others. "One maximizing strategy involves saving the most individual
lives, and it has motivated policies on allocation of influenza vaccines
and responses to bioterrorism. . . . Other things being equal, we should
always save five lives rather than one.
"However, other things are rarely equal—whether to save one 20-year-old,
who might live another 60 years, if saved, or three 70-year-olds, who
could only live for another 10 years each—is unclear." In fact, Dr.
Emanuel makes a clear choice: "When implemented, the complete lives
system produces a priority curve on which individuals aged roughly 15
and 40 years get the most substantial chance, whereas the youngest and
oldest people get changes that are attenuated (see Dr. Emanuel’s chart
Dr. Emanuel concedes that his plan appears to discriminate against older
people, but he explains: "Unlike allocation by sex or race, allocation
by age is not invidious discrimination. . . . Treating 65 year olds
differently because of stereotypes or falsehoods would be ageist;
treating them differently because they have already had more life-years
The youngest are also put at the back of the line: "Adolescents have
received substantial education and parental care, investments that will
be wasted without a complete life. Infants, by contrast, have not yet
received these investments. . . . As the legal philosopher Ronald
Dworkin argues, ‘It is terrible when an infant dies, but worse, most
people think, when a three-year-old dies and worse still when an
adolescent does,’ this argument is supported by empirical surveys."
(thelancet.com, Jan. 31, 2009).