Among the issues most commonly discussed are individuality, the rights of the individual, the limits of legitimate government, morality, history, economics, government policy, science, business, education, health care, energy, and man-made global warming evaluations. My posts are aimed at thinking, intelligent individuals, whose comments are very welcome.

"No matter how vast your knowledge or how modest, it is your own mind that has to acquire it." Ayn Rand

07 September 2009

Government Health Care Death Panels

Obama and the Democrats are fond of saying there are no death panels in their health insurance reform bills now in Congress. Of course, there is no entity called "Death Panel" in those bills. Neither is there a panel whose stated purpose is to kill patients or to assist patients in suicide. But, the government does intend to dictate the kind of care to be paid for by acceptable insurance plans with a mind to reduce costs. With an aging population, they are specifically complaining that the costs of patients in their last year of life is especially high and the expense of such people is going to continue to drive medical costs upward. The two stated reasons for passing their bills are to bring down costs and to insure the few Americans who are not insured, though they love to greatly inflate that number.

The United Kingdom has had a National Health Service since 1948. They also have a desire to contain costs. In 2004, the National Institute for Health and Clinical Excellence (NICE), the government's health overlook agency adopted the Liverpool Care Pathway (LCP) as the protocol to reduce patient suffering in their final hours. This was developed by Marie Curie, the cancer charity, but is now used for patients who have lost consciousness or are having difficulty swallowing medication. Patients are denied sustaining fluids and put under deep sedation using automated sedation syringe drivers, if a panel of the doctors treating them, including a senior doctor, recommends this. The procedure is used in more than 300 hospitals, 130 hospices, 560 care homes, and in 800 other instances, such as in patient's homes. In 2007-2008, 16.5% of deaths in Britain followed continuous deep sedation, which is twice the percentage in the Netherlands and Belgium.

According to a letter signed by Professor Peter Millard, Emeritus Professor of Geriatrics, University of London; Dr. Peter Hargreaves, Palliative Medicine Consultant at St. Luke's Cancer Centre in Guildford; Dr. Anthony Cole, Chairman of the Medical Ethics Alliance; Dr. David Hill, anaesthetist; Dowager Lady Salisbury, Chairman of the Choose Life Campaign; and Dr. Elizabeth Negus, Lecturer in English at Barking University, some patients have been wrongly put on the Liverpool Care Pathway. Patients who are allowed to become dehydrated can become confused, especially when on pain-killing drugs, and be wrongly put on the LCP. They are concerned that tick box medicine is replacing real thinking for those following this procedure. Many doctors are not checking patients often enough for progress and the sedation makes it more difficult to see if any progress is occurring. Dr. Hargreaves says he has taken patients off the LCP and seen them live for significant time after wards.

So, Death Panels do exist in the U.K.'s National Health Service. For the same reasons that they exist in Britain, they will also come to exist in the U.S. under a government-run health care system. Under such a system, they are inevitable, no matter how much politicians may wish to deny them now.

Of course, end of life decisions do have to be made. In a private health care system, they are made by the patient, the family, and the doctors treating the patient. But, after the government takes over the delivery of health care, as with all government activities, a bureaucracy takes over. One of the primary purposes of all the Democrat bills is to set up a huge structure of such agencies and advisory panels to grow into the controlling bodies for the takeover of all medical care in the United States. They have set up panels and groups to recommend effective treatments. They will deal with end of life issues and set up procedures similar to the LCP in Britain. In time, they will minimize the consultation with patient wishes and patient's families, as all government bureaucracies do. They will deal with patients and families as though one size fits all. This is the nature of the beast.

We will definitely find that we will also develop Death Panels if we go down this road. It is inevitable! And when these bureaucracies decide whether your mother will live or die, she will surely be thought to be of much less value than you think she is. This is also inevitable.

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