Friday, July 18, 2003

From blog correspondent Lee Penn
Medical nightmares that are a reality in the brave new world (order):

Age-based rationing of health care proposed by ‘bioethicist’

Lee Penn: .... the next step to 'control health care costs'?

Lee: It appears that the utilitarians of the left and of the right are embracing a
new form of social Darwinism. And at the end, traditional Christians will be
the only defenders of justice and mercy.

Lee: The guy who is putting the idea forward, Daniel Callahan, is 'well respected
in the bioethics field and has pushed the discussion toward the taboo'. Let
him ration his own care, and that for his own family.

Lee: Others may wish to follow up on Callahan's other activities and associations.
Is he a public supporter of abortion or population control? [Yes.] Is he Catholic?
[No. AFAIK he had the honesty to quit, years ago.]

UPI, 7/11/2003 [Extracts]
Analysis: Age-based health care rationing
By Ellen Beck

WASHINGTON, July 11 (UPI) -- America's struggle to pay for rising health care
costs leads people to consider the idea of rationing based on age -- a
discussion topic many consider ethically and morally taboo, yet necessary.

For a decade or more health care providers, ethicists, geriatricians, the
young and the old have danced around the subject of how much health care is
enough, how much is too much -- if that even is possible -- how should it be
paid for and who is entitled to it.

Daniel Callahan, director of International Programs at the Hastings Center in
New York City, told a panel discussion held by the Alliance for Aging
Research in Washington, D.C., this week, "We have to find some way to integrate
age as a standard or criterion for the allocation of resources" in health care.

The bottom line is people are living longer. Ancient Greeks lived only to
their 30s, but in the past 100 years life expectancy has soared past 65 and now
more people are living well into their 80s, 90s and beyond. It is also a fact
that older people consume more health care services.

Callahan is well respected in the bioethics field and has pushed the
discussion toward the taboo.

"We now have on our hands what I call the infinity model of medicine," he
said. It is the idea that we simply want more -- treatments, drugs, procedures,
technology -- without a guarantee of success in curing disease or extending
lifespan and without a limit on cost.

"I think that is increasingly unsustainable," he added.

The numbers are mind boggling for younger workers, who through payroll taxes
pay for a large chunk of Medicare expenditures. This brings up the issue,
Callahan says, of what the young owe to the old and vice versa.

He said the young owe the elderly the possibility of a decent old age, Social
Security, respect and an appropriate level of health care.

"The old at least owe the young not to take away what they need for their own
living conditions," he said. Health care should help young people live to old
age but "not to have old people become infinitely older."

"The notion of a lifespan, a life cycle, seems to make sense to me," he
added. "Beyond a point it is not a human tragedy that people die. ... It's good
for the species."

Dr. Roger Levy, a clinical professor of orthopedic surgery at Mount Sinai
School of Medicine in New York, who often writes about these issues, said
rationing health care based on age is "something that might not literally get
discussed because of the political implications," but will be part of the
general discussion of allocating resources.

He said efforts to rein in costs largely have focused on the supply side and
have not worked, whereas little has been done to curtail the demand side of
the equation.

Physicians and other health care experts can consider a wide body of
literature on the efficacy of various treatments, but they might or might not
include it all in the decision-making process.

There is concern rising costs will force families to contribute not only to
their own health care expenses but also to care for their parents or
grandparents. It brings up the potential of having to decide if Grandma gets a
hip replacement or Johnny goes to college.

Dr. Christine Cassel, president and chief executive officer of the American
Board of Internal Medicine, said seniors are making rationing choices for

"I don't believe that most older people are clamoring for artificial hearts
at age 95 ... What I see is a movement toward more palliative care, hospice.
There is a very strong basis for exactly the kind of democratic social movement
Dan (Callahan) is talking about," she said. "At a certain point those patients
themselves say it's time to stop."

Cassel said America spends a lot of money on health care treatments that do
not produce better quality and, as Levy does, supports rationing based more on
evidence-based medicine.

The religious perspective also will color this issue. Excluding any group,
including the elderly, from health care treatments could be seen as playing God
-- setting limits to that group's life expectancy. Christian and Jewish
doctrines are founded on the premise that all people are created in the image of
God and no one has the right to relegate anyone else to a lower status that would
shorten his or her lifespan.

Callahan said despite the public's perception at the moment, "age is not a
bad standard." He noted, however, that Congress would be unlikely to tackle any
legislation in this arena that does not receive huge public support. But
eventually, he said, people will come around and see "this is the only way to

(UPI's Religion Editor Uwe Siemon-Netto contributed to this report)

(Tim Macchio's comment: Instead of rushing in to discuss this issue, why
don't these people spend more time on eliminating the waste and streamlining the

Scientists create human ‘she-males’
Researchers combine male and female cells into one embryo.

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