“Dignity” is the new catchword in Washington. It was within the parameters of the newly created human right to “dignity” that Justice Kennedy wrote the majority opinion on gay marriage. Ever so quietly, without much public fanfare, Medicare is now attempting to move ahead on dignity in another arena of life – well not exactly life, more to the point, taking the final bow on the stage of life – death.
You might remember this remark made in 2009 by President Obama, who, when a member of the Illinois Senate was supportive of infanticide, that seniors are getting too many procedures and maybe they’re “better off not having the surgery, but taking the painkiller.” And here it is, The Advance Planning and Compassionate Care Act of 2014- S. 3009 , which can best be described as nothing less than an ongoing slick, Madison Avenue public relations blitz to convince the senior of the efficacy of taking that painkiller and taking that painless “dignified” bow. It even co-ops your personal physician by instituting, of course paid by Medicare, repeated meetings with him\her every few years to discuss your final bow on the stage of life – of course, need I say it again with “dignity.”
I guess this is the way the President is going to save some money, allocating it in more appropriate ways. As the Institute of Medicine has declared – this will help free up cash “to fund highly targeted and carefully tailored social services for both children and adults.” Too bad we do not live in colder climes where we could simply employ “Senilicide” as was once rather common among the Inuit (Greenland to Northern Alaska). Just place Grandpa on the ice flow and wish him a bon voyage. Who knows, we may yet be able to reinstitute this custom of the Inuit as global warming enthusiasts now claim that this theory includes global cooling. As you may recall in the mini Ice Age, a polar bear was cited on the ice flow in the river Thames in London. I can’t resist – as the old saying goes where there’s life there’s hope.
What is the source of this purely economic view of life? You may remember when Dr. Ezekiel Emanuel, brother of Chicago’s Mayor, was hitting the talk show circuit explaining the virtues of Obamacare. It is worth revisiting the good doctor’s views on health care as he was a major player in the creation of Obamacare.
Dr. Ezekiel Emmanuel, healthcare guru to President Obama, wrote the following in the Feb. 27, 2008, issue of the Journal of the American Medical Association (JAMA): “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely ‘lipstick’ cost control, more for show and public relations than for true change. True reform, must include redefining doctors’ ethical obligations.”
In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the Hippocratic Oath for the ‘overuse’ of medical care. “Medical school education and post graduate education emphasize thoroughness. This culture is further reinforced by a unique understanding of professional obligations, specifically the Hippocratic Oath’s admonition to ‘use my power to help the sick to the best of my ability and judgment’ as an imperative to do everything for the patient regardless of cost or effect on others. He stated, “The progression in end-of-life care mentality from ‘do everything’ to more palliative care shows that change in physician norms and practices is possible.”
Emanuel’s belief that Doctors’ approach to healing must not only consider the needs of the patient, but also the “cost and effect on others,” is the basis upon which government health care, as I experienced it in the United Kingdom, functions. It is the only way it can function as the traditional view of the Hippocratic Oath is not doable in such a system.
We already saw an example of this in Secretary Sebalius’ refusal to allow a heart transplant to be given to a young child. It was only through the intervention of the Court that this precious life was spared.
During my sojourn in the U.K. over three decades ago, I was treated to the harsh reality of national health care. Our local health board in Manchester needed to supply our hospitals with six additional dialysis machines to meet the needs of the growing patient load which required this service to maintain their very lives. Unfortunately, their budget granted them by the Federal government was far less than required. They were left to review their needs – forced to make adjustments. One adjustment that was decided upon was not to purchase any additional dialysis machines as in the eyes of the Board there were many more pressing issues that needed attention.
Letters were sent to those designated “unworthy” of future dialysis treatment. Those on the dole, the elderly, and others determined as Dr. Emmanuel would put it, based upon their “cost and effect on others,” were singled out for a letter. The letter simply told the recipient that he/she need not come to Hospital any longer as dialysis would no longer be available. It was a “death notice” issued by a “death panel.”
Our Jewish tradition requires that a Bikur Cholim, a committee be set up in every Jewish community to maintain medical care for all – Rabbi, farmer, philanthropist, worker, the poor, the beggar and the senior alike. The community and the individuals residing in that community would have to prioritize spending. Those responsible to collect communal funds from the individual would establish the sum to be given and even could force, if necessary, the payment of that sum by the individual through the Bet Din – religious court. I do not believe they would view as a priority in one’s budget, season tickets at Wrigley Field, for example, as superseding ones obligation to provide for the healthcare of society.
I cannot and will not believe that Americans want their doctors or hospitals to be guided in their provision of medical care by a lay body who effectively, in line with Dr. Emanuel’s ethics, determines what medical care, if any, an individual will receive, not only by the need of the patient but by the impact such care will have upon society as a whole. As in my example from the U.K., they would essentially determine the person’s value to society. Does he work, is he productive, does his life have a meaningful impact on others, his probable years of life he might yet live, a new Unesaneh Tokef, this time in the hands of humanity – “Who shall live and who shall die.”
Many times, when confronted by the mourner with the painful question of why their loved one died, I have responded that, in theory, the issue of life and death can remain in G‑d’s hand or we could demand to play a role in determining who shall live and who shall die to insure our sense of fairness is in play. For me, I opt for the present situation, accepting that at times the G‑dly decision will be one I cannot fathom and may even disagree with, rather than have to sit on the celestial “death panel.”
Don’t you agree with me? The path our society is now on with regard to health care is morally wrong, un-Jewish. It needs to be changed. Considering the “quality” of another’s life begins the slippery slope toward euthanasia and worse. That the Jew was considered, evaluated, to be a non-human race of vermin, was the “justification” for our slaughter by the Nazis. We need to learn from history rather than embarking upon a path, G‑d forbid, toward reliving it.