Tuesday, May 12, 2009

Is Obama the First Pro-Euthanasia President?

There’s been very little attention paid to an interview President Obama did with the New York Times the day of his major speech at Georgetown University on April 14. I was especially interested in the section of the interview dealing with health care, and to learn of the President’s perceptions of end-of-life issues. It’s not pretty. Read on.

For starters, President Obama opined:
I have always said, though, that we should not overstate the degree to which consumers rather than doctors are going to be driving treatment, because . . . when it comes to medical care; I know how to ask good questions of my doctor. But ultimately, he’s the guy with the medical degree. So, if he tells me, You know what, you’ve got such-and-such and you need to take such-and-such, I don’t go around arguing with him or go online to see if I can find a better opinion than his.
Well, yes and no.

But the President’s slant is immediately concerning, because there’s a fine line between medical expertise and Doctor Power. What if the doctor says, “Well, you’ve got two weeks to live, and your quality of life is very poor, and all the expensive care we can give you will not help a bit, but assisted suicide is legal, quick, and very inexpensive?’ Should I then accept this pronouncement because he’s “the guy with the medical degree?”

If you think I’m stretching things a bit, it’s because of what came next from the President:
And part of what I think government can do effectively is to be an honest broker in assessing and evaluating treatment options. And certainly that’s true when it comes to Medicare and Medicaid, where the taxpayers are footing the bill and we have an obligation to get those costs under control. And right now we’re footing the bill for a lot of things that don’t make people healthier.
Not too hard to see the spin here. Now we’ll get the government saying, “OK, seeing that we pay for your medical care, we’re going to decide what care you get and what care you can’t have.”

And, more darkly, the specter of futile care emerges, because what the President was saying was, “If we’re paying for stuff that doesn’t make you healthier, we need to reconsider whether we want to pay for this treatment.”

Note the phrase is “to make you healthier” - not to alleviate your symptoms, or provide you with comfort care because you’re never going to get healthier.

Simple: If treatment makes you healthy again, you get it. If it can’t, you can’t have it, because we need it for people who can get healthy again.

Pure, unadulterated futile care.

Here’s what will happen, trust me:

The government already knows that medical care in the last weeks of life is where most medical dollars get spent. Same goes for money spent on people with significant, although not necessarily terminal disabilities. Marry that to the President’s commitment to cut health care costs, a society that increasingly thinks helping people die is just dandy, and a medical profession that is increasingly utilitarian, and you have the perfect plan to make people with severe medical problems, including those with disabilities, into Useless Eaters.

It got worse.

The President:
So when . . . I talk about the importance of using comparative-effectiveness studies as a way of reining in costs [which] . . . is an attempt to say to patients, you know what, we’ve looked at some objective studies out here, people who know about this stuff, concluding that the blue pill, which costs half as much as the red pill, is just as effective, and you might want to go ahead and get the blue one. And if a provider is pushing the red one on you, then you should at least ask some important questions.
Ah, “comparative-effectiveness,” “objective studies.”

Science in the service of deciding who lives and who dies. Seems like we’ve heard this somewhere before.

Allow me to paraphrase my President:

Doctor to patient: “You know, what, we’ve looked at some objective studies out here, people who know about this stuff, concluding that there’s no point in treating you any further. We’ve concluded that the blue pill, which will keep you comfortable until you die, is very expensive. The red pill, that costs a tiny fraction of the blue pill, can end your suffering quietly, effectively, and with dignity.”

Don’t believe me? See what happened to Barbara Wagner in Oregon, where the state refused an expensive treatment to help her live our her days, but offered to pay the pennies it would cost for her to commit assisted suicide.

But the President went even further, using a personal example when asked about end of life care:
. . . my grandmother got very ill during the campaign, she got cancer; it was determined to be terminal. And about two or three weeks after her diagnosis she fell, broke her hip . . .So now she’s in the hospital, and the doctor says, Look, you’ve got about — maybe you have three months, maybe you have six months, maybe you have nine months to live. Because of the weakness of your heart, if you have an operation on your hip there are certain risks that — you know, your heart can’t take it. On the other hand, if you just sit there with your hip like this, you’re just going to waste away and your quality of life will be terrible. And she elected to get the hip replacement and was fine for about two weeks after the hip replacement, and then suddenly just — you know, things fell apart . . .
OK, a very difficult situation, with difficult, but very common health decisions that needed to be made. BUT, then the President went on, back to setting us up for official pro-death thinking:
Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn’t have a hip replacement and she had to lie there in misery in the waning days of her life — that would be pretty upsetting.
See? Old, lying in misery in an expensive hospital bed, with a broken hip.

Pretty upsetting. Expensive, too.

What’s a grandson to do?

The President:
Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.
Just so you know: Pro-death is going to be more than law. Here's the plan:

Have “conversations” with the public under the guise of measured reasonable argument. Subtly (and not so subtly) use doctors, scientists and ethicists who are pro-death to lead the way. Shape public opinion to utilitarianism, futile care, people as pure economic entities, and then the resistance to assisted suicide, and, eventually, euthanasia, will crumble.

Is Obama our first pro-death President?

I see no evidence that he’s not.


Anonymous said...

Nice analysis Dr. Mostert.
I suffer from a debilitating connective tissue disorder which has very quickly caused me to lose organs (one kidney) and aortic dissection, heart valve problems etc. I now face a new series of surgeries which will convert me formally into that feared “useless eater”. Oddly, I faced my disabilities rather productively (obtained Ph. D. in medical science and contributed in the development of new drugs). In my short career of 20 years, (I am 47 now) I earned lots of money and paid lots of taxes into the system. I am now at the mercy of the Government, as a break up of the family (disability and marriage don’t get along) has nearly bankrupted me. The future is indeed grim.
Lawmakers and the Courts, have in essence continued to view disabled people as a burden, while being careful not to be explicit about it. Issues of racism or ethnic or religious identity is seen in serious terms (as it should be). Disability however, is seen as a “solved problem” by many in society today. In fact the final solution (pun intended) is assisted suicide or "titrated" care. Surprisingly, it has become increasingly rampant in the ostensibly “liberal” community. One expects very little if any, from the conservatives as they have always couched it in terms of personal responsibility under the covenant of a GOD(!)etc. The current economic contraction will certainly expose us to a new compassion as opposed to the “compassionate conservatism” of neo conservatives like George W. Bush. Wars are profitable we are not. We wont even fit in those uniforms.

Anonymous said...

Dear Anonymous -
Very sorry to read of your very difficult circumstances. I thank God for your life, your contributions to society, your 'hidden' blessings to family, friends, colleagues, right up to this very moment and for all of your natural life.
As a conservative, from whom you 'expect very little if any[thing],' I can't help but refocus your attention on the alarm bells being rung so loudly and clearly - on your behalf and that of everyone like you - by the Dr. Mosterts and the Regent Universitys and the Wesley Smiths and the Terri Schindler Schiavo Foundations and the Euthanasia Prevention Coalitions and the millions of others of us conservatives who not only want your life protected until its very last natural moment but who are financially supporting the myriad PRIVATE organizations dedicated to defending your right to life, finding cures for your disabilities and standing ready to care for you when you can no longer care for yourself.
Those in the 'ostensibly liberal community' whom you say are now 'surprising' you with their support for assisted suicide and 'titrated care' should be coming as no surprise at all. Theirs has always been a 'government' solution to your problems, which has been historically certain to betray you - and all of us - as soon as 'government' comes into the hands of those unmoved by Christian principles of human dignity and worth, regardless of capability, those bent on aggragating to themselves as much power as they can [always for the 'benefit' of those who are far less capable than they], and those who decide that 'government's' money is better spent elsewhere.
In the meantime, they have confiscated so much of my 'conservative' money in taxes -to be spent on what they think more important than your life and dignity - that I am no longer able to support those private organizations that were working so hard to defend and assist you.

Anonymous said...

The trouble is we have a one party "corporate" government. Progressives (old fashioned liberals in the literal sense, --Republicans and Democrats)are virtually gone. Endless wars with billions spent on no bid contracts for the select few, has nothing to do with true conservatism of the Eisenhower type. He warned us about the Pentagon and it is now eating 700 odd Billion dollars every year and cant even account for it properly. I have nothing against religion (I am a secular humanist and atheist) but believe Government should be involved in this matter rather than organizations which can get limited by funds or get taken over by dogma of any kind. Good elected government can be neutral and be held accountable. We have chosen to "corporatize" them with lobby groups. Time for campaign finance reform from the ground up at the local level. Citizens are too apathetic in this country. The entire tax code should be revamped to reflect progressivism and compassion.

Unknown said...

Have you ever heard of the New World Order?