Allocating medical care based on the subjective judgment of the value of a patient's life is contrary to Catholic teaching. The value of treatment to any given patient can be ethically evaluated, but every patient's life is of inestimable worth. See this article for a more detailed discussion of the moral principles applied to health care rationing.
Those advocating for President Obama's health care reform label concerns about rationing of care and denial of care to the elderly and disabled as irrational and the product of fear mongering. However, if you read the work of Dr. Ezekiel Emanuel, who is the health-policy advisor at the White House Office of Management and Budget (OMB) and a member of the Federal Council on Comparative Effectiveness Research (FCCCER) and also the brother of the President's Chief of Staff Rahm Emanuel, these concerns seem very reasonable indeed. The current legislation does not specify medical treatments to be covered. Rather, it delegates these decisions to a Health Benefits Advisory Council. This panel is advised by the FCCCER. That is why the ideology of Dr. Emanuel is very relevant to concerns about rationing of health care.
In January, 2009, Dr. Emanuel published a paper in the Lancet [Persad, Govind, Alan Wertheimer, and Ezekiel J. Emanuel. "Principles for allocation of scarce medical interventions." The Lancet 373 (Jan 31,2009): 423-31]. In it he argues for the use of a "Complete Lives Systems" method of allocating care. From the abstract:
We recommend an alternative system--the complete lives system--which prioritises younger people who have not yet live a complete life and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.
In defending this approach against charges of ageism, Dr. Emanuel claims that because everyone was young once, prioritizing the young over the old is not discrimination:
Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different states rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years.
This system also treats human beings as commodities, evaluating their lives as "investments":
Consideration of the importance of complete lives also supports modifying the youngest-first principle by prioritising adolescents and young adults over infants. 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. Similarly, adolescence brings with it a developed personality capable of forming and valuing long-term plans whose fulfillment requires a complete life.
Lifesite News reports that in a Hastings Center Report, 1996, Emanuel also spoke of denying care to the disabled:
In a separate 1996 article for the Hastings Center Report, Emanuel spoke about rationing care away from those "who are irreversibly prevented from being or becoming participating citizens" to the non-disabled, adding "An obvious example is not guaranteeing health services to patients with dementia."
This is the ideology that will be guiding the Health Benefits Advisory Council in the current health care reform legislation.
For more info:
Full text of Dr. Emanuel's Lancet article
Health Care Rationing is contrary to Catholic moral principles
Comments
"All people are equal, but some people are more equal than others." Sound familiar, Dr. Emanuel?
According to his principles, people between the ages of 15 and 40 are the only ones who would be guaranteed the best care. That means that in my family of 5, worse-case scenario, only ONE would be treated.
With advisors like Emanuel, is anyone surprised by this so called 'health care'? I hate to remind all us old folks of this, but, in a country like ours since 1973, and with people like this voted into office, where the very beginning of life is not respected from the moment of conception, where the unborn children of our future are not wanted and are discarded, we can expect things to get a lot worse. Why would they want people who are sick or old, when they don't want new life? The line of decency and respect for all life was crossed all those years ago. And we have our Supreme Court to thank, along with selfishness and greed for power. We get what we deserve, and that is looking more and more bleak.
We have obviously very different reading comprehension skills. RE: Principles for allocation of scarce medical interventions, Dr Emanuel is one of three authors. These gentlemen have created an academic paper addressing a difficult topic. It does not advocate witholding normal treatments to healthy although disabled or aged patients. Rather, it strives to look at the moral and ethical components of the decision making that ALREADY OCCUR IN EVERY EMERGENCY ROOM, HOSPITAL, ORGAN DONOR BANK. If you don't like their opinions, how would you answer these questions? Of a number of potential recipients, who gets the single matching heart? At a hospital in the heart of an occuring natural disaster, who of the 170+ critical patients gets the 50 ICU beds? If production of flu vacine falls seriously low during a pandemic, who should be vacinated first?
When medical professionals are asked to incorporate the utility of the patient into their medical decisions then we have crossed the line of moral acceptability. Dr. Emmanuel clearly does this. He judges what the patient has to offer the community in order to triage scarce resources. Who is going to be the judge of which patients better serve the "greater good"? His concept that a 15-year-old is more worthy than a 3-year-old because there has been more of an investment in the education and formation of a 15-year-old reduces human life to a commodity.
this article falsely states that Dr. Emmanuel's paper pertained to the general allocation of medical care in society. That is a lie. The article clearly pertains to the very special and difficult case of transplant surgery where where there are fewer transplant organs available than there are eligible recipients. It is deplorable that the author of the article above would besmirch the reputation of a respected oncologist and medical ethicist like Dr. Emmanuel. Why did you choose not to mention the fact that Dr. Emmanuel has repeatedly written in opposition to euthanasia?
And, by the way, the current proposed legislation does not delegate to a feferal panel which medical procedures will be permitted. Another lie.
uh, nyp, you are not being honest here. The article isn't just about transplants, where I guess there could be some understanding of "allocating" a single available heart to someone younger, but it is inclusive of ALL higher end medical care.
Rather than what we have now, where the hospital, doctor, and patient are decision makers, it advocates a formula that takes freedoms away from all of these parties. Furthermore, we know that if we turn things over to the gov't, the scarcities we have in our health care now will only get worse.
Thank god for people like Emanuel who are addressing these HARD questions. Do you think that burying your head in the sand is going to solve anything?
Disappointing, low-intelligence article from the Examiner, once again.
Wonderful comments from readers, though. How about placing the comments first, before the article. That way readers would read quality thoughts before the made-up stuff.
Mike shut up. Dr. Emanuel represents everything this country doesn't stand for.
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