Posted on 10/01/2011 12:50:16 PM PDT by wagglebee
“Get out of the lifeboat you expensive terminal cancer patients! Sure, your lives could be extended months, maybe even years,–but it isn’t worth the money! You’re going to die sooner or later, so it might as well be sooner. We need the money for more important and productive patients.”
That, in a harshly stated nutshell, is the recommendation of a committee of doctors in Lancet Oncology who recommend money by rationing therapies that don’t save the lives of cancer patients, but can extend their lives. From the Daily Mail story:
Patients with terminal cancer should not be given life-extending drugs, doctors said yesterday. The treatments give false hope and are too costly for the public purse, they warned. The group of 37 cancer experts, including British specialist Karol Sikora, claimed a ‘culture of excess’ had led doctors to ‘overtreat, overdiagnose and overpromise’…’We clearly would want to spare the patient the toxicity and false hope associated with such treatment, as well as the expense,’ the experts told the European multidisciplinary cancer congress in Stockholm.The doctors point out that many patients do not want to spend their final days undergoing exhausting chemotherapy in hospital and would rather be at home surrounded by loved ones.
Oh, quit pretending that it’s for the patient. It’s about money.
Indeed, we are now seeing a drive to extend the cancer of Futile Care Theory beyond ICU-style life-sustaining treatment, to other forms of care in which the patient may not even be hospitalized. When I was researching Culture of Death, I interviewed an advocate of medical futility and noted that refusing ICU treatment wouldn’t save a lot of money. I asked, what will futilitarians try to cut next? He responded, “marginally beneficial care.” And here we are.
Don’t get me wrong. I support people deciding not to go for the last shot of chemo, with the terrible side effects that can bring. But the decision should not be up to the doctors to withhold what is, after all, efficacious treatment that extends life. Doctors should give clear and honest pros and cons of the treatment–including onerous physical effects–but it should be up to the patient to decide whether the time has come to enter a hospice situation.
Patient advocates are pushing back:
But a spokesman for the Rarer Cancers Foundation said: ‘Describing all treatments near the end of life as futile is tantamount to writing patients off. ‘Just because they cannot be “cured” does not mean that we cannot give them valuable treatment, care and support.’ Ian Beaumont of Bowel Cancer UK said money was not the sole issue. ‘While cancer care can be expensive, it is unjust to put a cost on the lives of patients, especially when modern treatments can often give them precious time with their loved ones and increase their length and quality of life,’ he added. Only last week a pill for prostate cancer, Abiraterone, was made available in the UK for the first time at a cost of £35,000 a patient. Although on average it only extends lives by a few weeks, some patients survive for five years.
We all have our stories. When my dad was dying of colon cancer–for which he generally received awful care (I now know) from the Veterans’ Administration–doctors very reluctantly offered him a last ditch chemo that might give him a few months, with terrible side effects. He took it, and the cancer actually went into remission for a year. Not only that, the side effects were few. Indeed, it was a time of relative health for my dad, in which he and mom traveled and he thoroughly enjoyed every minute.
Bottom line: By accepting the philosophical premises of Futile Care Theory, bioethicists have opened the door to now imposing greater restrictions in the name of “fairness.” We should not let utilitarian central planners to take away hope and create a putative “duty to die.”
Unfortunately, the utilitarian death mongers are getting louder by the day.
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I’ll bet that won’t apply to those with connections. Just the hoi polloi.
"Death panels?"
Can't be. Sarah Palin predicted Death Panels.
... and we all know that she's soo-ooo-ooo stupid.
Hello. Everyone is going to die some day, sooner or later.
By their twisted reasoning of productivity, then, they should be denying medical care to those on welfare, criminals, and illegals, those who are not be holding down jobs and paying taxes as productive members of society.
There, fixed.
As long as the patient is spending his own money, I could not agree more.
AIDS is terminal.
Will they pull the plug on life extending treatment for AIDS patents, too?
What about cystic fibrosis?
Any death panel member should be faced with quantifying what one more year of life for their child or their spouse or themselves, is worth.
There, fixed.
Just a few questions:
1. Do you have health insurance? YES or NO
2. Do you now or have you ever had payroll taxes withheld from your pay? YES or NO
3. Do you pay ALL of your medical expenses out of your own pocket? YES or NO
4. Are you aware of a single state where employers are required by law to provide health insurance? YES or NO
Let those who support and implement it to be the first to use it on themseves and thier family! It’s great to open your mouth and sh## comes out until you have to eat that sh##.
What else would it be for?
As long as the patient is spending his own money, I could not agree more.
Health insurance is a private contract between the enrollee and the health insurance company.
Yet you "compassionate libertarians" would deny them care if in any way you think it might somehow cost you a penny.
A society that refuses to properly care for its sick and dying is not worth preserving.
I know a 90 year old guy who was told around this time last year that he was dying of cancer during his last hospital stay. The first question out of his mouth was, “when can I return to work?” He receives hospice care at home everyday and on days he works, after they leave, he hops into his car and goes to work, shopping or whatever he need to do. He looks a bit better the last time I saw him. I think there is a lot more to this, the will to live and so on.
We're not talking here about the simple care that would have kept Terri Schiavo alive.
We're talking about drugs, surgeries, implants and ICU stays that can consume a single taxpayer's yearly income in three days.
Now if you really believe that the taxpayer has an unlimited duty to pay for those services, a duty that is enforced by the force of law, then say so.
But don't pretend that it's all free, OK??
The only people for whom this argument would hold true are Medicaid recipients and a small subset of Medicare recipients. We can debate their situation if you like.
Everyone else has paid into a health insurance plan, and has the right to receive adequate health care in return for their investment.
If you'd like to make the distinctions that are proper to your actual argument, we can then proceed with debate.
Otherwise, your claim that taxpayers are responsible for the medical care of private health insurance enrollees is simply ludicrous and unworthy of further reply.
Six years ago this month I was told I had six months to live even with surgery. I had the surgery but refused the cemo. Went back to work in a week and I am still here with no sign of cancer.
and a small subset of Medicare recipients
There are some reasonably sound calculations to the effect that the average Medicare beneficiary receives 2-3x the value of his contributions to the program (including interest) over his lifetime. No one will have paid in more than $120,000 or so even at very high levels of taxable income.
And once the benefits received exceed the time value of the money paid in, yes, the Medicare beneficiary is being directly subsidized by today's employers and workers: the aging of the population will make this even more so in future.
Medicaid recipients .... We can debate their situation
Yes, I would like to know whether you believe Medicaid patients have an inherent right to every extremely high cost albeit life saving treatment, and if not, who makes the decisions.
and has the right to receive adequate health care in return for their investment
Now that we've dealt with the "return on investment" by Government, we can also discuss whether private insurance companies should be required to cover the most expensive, most cutting edge therapies to every one of their clients whose doctor desires to provide it, regardless of actuarial soundness. Who shall be assessed for the extra dollars required? Do the existing policyholders get a choice as to whether they want to pay for this coverage or not?
As is the question of taxpayers being forced to pay because the British pay extremely high taxes to pay for their health insurance.
Yes, I would like to know whether you believe Medicaid patients have an inherent right to every extremely high cost albeit life saving treatment, and if not, who makes the decisions.
Define "high cost." Is it $1 million? If so, why not $100?
Give us a number where you think a death panel should be permitted to end a person's life.
What about my questions from earlier, you never answered these:
1. Do you have health insurance? YES or NO
2. Do you now or have you ever had payroll taxes withheld from your pay? YES or NO
3. Do you pay ALL of your medical expenses out of your own pocket? YES or NO
4. Are you aware of a single state where employers are required by law to provide health insurance? YES or NO
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