Tuesday, August 11, 2009

Obama's Death Panel

Sarah Palin has kicked off (another) firestorm of criticism because of the statement she released on herFacebook page:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

The incoming fire has been withering, as usual. Palin is accused of becoming the "Zombie Queen," certifiably insane, "clinically wrong," and espousing a "gruesome mix of camp and high farce."

These critics, however, didn't take the time to find out to what Palin was referring when she used the term "level of productivity in society" as being the basis for determining access to medical care. If the critics, who hold themselves in the highest of intellectual esteem, had bothered to do something other than react, they would have realized that the approach to health care to which Palin was referring was none other than that espoused by key Obama health care adviser Dr. Ezekial Emanuel (brother of Chief of Staff Rahm Emanuel).


The article in which Dr. Emanuel puts forth his approach is "Principles for Allocation of Scarce Medical Interventions," published on January 31, 2009.


While Emanuel does not use the term "death panel," Palin put that term in quotation marks to signify the concept of medical decisions based on the perceived societal worth of an individual, not literally a "death panel." And in so doing, Palin was true to Dr. Emanuel's concept of a system which

"considers prognosis, since its aim is to achieve complete lives. A young person with a poor prognosis has had a few life-years but lacks the potential to live a complete life. Considering prognosis forestalls the concern the disproportionately large amounts of resources will be directed to young people with poor prognoses. When the worst-off can benefit only slightly while better-off people could benefit greatly, allocating to the better-off is often justifiable....

When implemented, the complete lives 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.

Put together the concepts of prognosis and age, and Dr. Emanuel's proposal reasonably could be construed as advocating the withholding of some level of medical treatment (probably not basic care, but likely expensive advanced care) to a baby born with Down Syndrome. You may not like this implication, but it is Dr. Emanuel's implication not Palin's.

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