“Don’t mention death panels!“ the medical technocrats often scream–as they plot and plan to institute death panels.
And that’s just the course taken by the New York Times physician columnist, Sandeep Jouhar, as he races past supporting Futile Care Theory–in which doctors are permitted withdraw wanted life-sustaining treatment based on their subjective moral views about the patient’s the quality of life–to advocate imposing a regimen of “social justice” onto the practice of medicine. From, “It’s Not Just About ‘Quality of Life.”’
Critical care physicians, patient advocates and other experts should come together to establish uniform standards to govern futile care. Hospital review boards should uphold these standards, even in the face of political pressures. Hopefully, states would write legislation that would adhere to these principles.
Unfortunately, there is as yet no consensus on how to balance the competing ethics in these disputes. No doctor wants to go against a patient’s or family’s wishes, but we also want to avoid treatments whose risks and burdens exceed their benefit.
Embracing the ethic of social justice can help us out of this morass. Social justice in medicine promotes the allocation of limited resources to maximize societal benefit. For example, we don’t usually offer heart transplants to patients over 70 years of age. Scarce goods, such as health care, should be distributed fairly.
Talk about opening the door to invidious medical discrimination against the elderly, disabled, chronically ill, terminally ill, and devalued.
Think very carefully about this: In a “social justice” medical regime, your physician would no longer be a fiduciary to you–perhaps the most fundamental aspect of the professional relationship. Rather, she would have dual loyalties–and in some cases, her duty to the state would trump the desires–and indeed, the very life–of the patient by refusing efficacious care that extends life. (And don’t think it would stop in the ICU.)
But Jouhar tells us not to call that death panels!
Far better for us to decide that we cannot afford to pay for nonbeneficial care.
We need to have this discussion without alarmist rhetoric about “death panels.” Rational judgments about endoflife issues should not give way to idiosyncratic desires.
In other words, extending life when that is what the patient wants is not beneficial. That turn’s the purpose of medicine on its head.
Here’s the bottom line–and I have documented it elsewhere–medical technocrats want death panels. They would just prefer a less provocative name, so they call it “social justice.”