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Saturday, March 5, 2011

Government Death Panels, Alive and Kicking

Baby Joseph of Canada has dropped from the mainstream media, but his plight continues. The boy cannot breathe on his own due to a severe but specifically undiagnosed neurological problem. His parents want him to have a tracheotomy to get him off the respirator, and the Canadian health system refuses to perform it, saying it is too risky. They also believe Baby Joseph has no chance at recovery and will die in any case.

So they simply wish to remove the respirator and let him die.

Note the irony: They do not want to perform the tracheotomy because it’s too risky. I don’t know what the risks are, the news didn’t specify them. I can’t imagine any risk being greater than certain death. “No, the tracheotomy has too much risk of adverse consequences. It would be far less risky for the patient if he were to die.”

Give me a break.

In all the international, public controversy, they have delayed their plans and have offered to disconnect the device at the parents’ home.

The parents want to bring him to the US to get the procedure done, but so far no hospital has agreed to take the case. In fact, Children’s Hospital of Michigan in Detroit has reviewed the case and refused to take it, even after initially saying they would.

Now, in US politics, when President Obama’s health reform plan was being debated, people talked about it establishing government death panels. Supporters of “Obamacare” derided those who worried about the death panels, saying it would be preposterous.

Yet let’s look north a bit, just above our borders, to Canada and see what is happening there. Right now, Baby Joseph’s life is in the hands of the Office of the Public Guardian. That governmental office will decide if and when to remove Baby Joseph’s respirator, and it can make that decision autocratically.

Folks, that is what a death panel looks like.

We might imagine a special conference room in some government office somewhere, with a folder of a patient’s medical records on the table. People in business suits or white coats sitting around the table, looking at various pieces of paper from the folder. Then, someone says, “Shall this patient die? All in favor?” Hands go up around the table. A majority vote. The patient dies. A new folder is brought forth….

The Canadian death panel looks far different. But it is what it is.

Canada rations healthcare. Some people like Baby Joseph use a lot of healthcare. Too much, in fact. A death panel is whoever is authorized by law to decide that a patient like him has used enough health resources and to let him die. It is a “government” death panel whether or not the person(s) involved are government workers because it is authorized by the government.

One could make a car analogy. If you have a car, say, a go-kart, that is too small to be of practical value for commuting or shopping, and it needs constant mechanical attention just to run, and you can’t take it out of the shop, and it has no hope of ever being repaired – what do you do? You get rid of it, right? But couldn’t you, if you wish, keep it? Couldn’t you bring it home to tinker with it? Couldn’t you change mechanics if you pleased? Of course you could.

And what if the mechanics refused to let you even look at your go-kart? What if they abdicated all their responsibility to you, and handed things over to a government agency? What if that government agency wants to force you to scrap it, but is only waiting to decide when? It would be absurd.

But that is only an analogy. We’re talking about a human being. The baby is too small to be of use to society in terms of working or consuming. He needs constant attention and will never recover. And his parents are completely helpless, powerless to do anything.

One way to bring down healthcare costs is by limiting how much healthcare people use. If people stay healthy, they will use the health system only when they need to, and even then not use health services and products unnecessarily. People also have to be less sue-happy with their doctors. And they should not expect insurance companies to pay for everything, because insurers will always charge premiums that are more than they pay out.

Another way to reduce costs is to limit how much healthcare everyone can get. This will begin by reasoning that only those “who really need it” will be able to get it. But then…

…who are those “who really need it”? Who are those who will make that decision? Will not the criteria have to be put into law?

The Canadian government authorities have decided that Baby Joseph is someone who does not really need the care he is getting and should get no further care.

Maybe the care he is receiving is futile and should be discontinued. There is no ethical obligation to use futile and burdensome care. However, there are two issues here that must be considered.

One is, are all possible alternatives, such as that proposed by Baby Joseph’s parents, equally futile and burdensome? The lack of US hospitals willing to step suggests that may be so. On the other hand, there may be other (political) reasons the US hospitals haven’t offered any help – or maybe I’m just getting paranoid about that sort of thing.

There other is who makes the decision that care is futile and burdensome?

In Canada, it is the government’s choice. The government chooses who gets healthcare and how much.

And that is what a death panel looks like.

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