yes, those are certainly high-profile cases, but not what we usually see "down in the trenches" where common sense prevails in the absence of governmental-intrusion.
I happen to agree with you on many aspects of this discussion. Just as an example, let's look at the history of End Stage Renal Disease (ESRD). From Wikipedia, with my underlings:
"In 1972 the US Congress passed legislation authorizing the End Stage Renal Disease (ESRD) program under Medicare. Section 299I of Public Law 92-603, passed by Congress on October 30, 1972, extended Medicare coverage to Americans if they had stage five chronic kidney disease (CKD) and were otherwise qualified under Medicare's work history requirements. The program's launch was July 1, 1973. Previously only those over 65 could qualify for Medicare benefits. This entitlement is nearly universal covering over 90% of all US citizens with severe CKD."
So there you have it. Entitlement. Known otherwise as OPIUM or OPM - other peoples money.
Before that, at my institution, there was a diversely-made up "panel" to see if it was the right thing to do (for those patients considering using the improving field of dialysis and transplant) from a personal, social, economic, medical and other perspective. After that, the government had basically decreed that no one should die of kidney failure even if they were hopeless, useless, nursing-home bound, brain-damaged, prisoners, etc. The pendulum had swung way too far over those years and seemingly is now swinging the other way. So rather than using a sound-bite to call the proposed decision-making panels "death" squads, maybe they should be called "common sense" squads. On the other hand, are such panels needed, versus, say just the discussion between patient/family/physician? But the scenario is more difficult when there is no family, or the patient is unable to understand or communicate for a variety of reasons from medical to language barriers, intelligence, etc. Who gets to decide? The bean counters? At some point the answer is yes, they need to be involved as well. How much is a life worth? A former useful life worth? A no-hope life worth? An illegal alien life worth? A drug-crazed high school dropout life worth? A 90 yr old nursing home resident with hip fracture? And so forth.
This is a Gordian Knot.
Thanks everyone, for this discussion, beginning with Ken's post.
