>>We must join together, by the hundreds of thousands,
>>if not millions, and remind them of it.
Even the longest journey begins with a single step. . . .
Posted on 08/06/2009 6:40:46 AM PDT by Jeff Head
Ezekiel Emanuel is no different than the Nazis who sought to save the Reich money by killing those unfit and inferior. He is seeking to recreate the holocaust for the aged and infirm.
This is truly the face of evil. The problem I’m running into is that some of the people at work don’t believe these sorts of quotes because they can’t believe that anyone is really so evil and even if they were they wouldn’t actually say it out loud...so they assume it must be something taken out of context. Essentially, true evil is so extreme that people can’t accept that it exists.
I do not know what they represetn...but I do know that Obama willfully chose a Dr. to advise him who talks about the fundamental trappings of infanticide and Eugenics like they are his own.
it's twisted, sick, and perverted...it is also scary and dangerous and something we simply cannot allow to stand.
everyone we know should hear or read these quotes. I am confident that the absolute vast majority of Americans will turn away from it in horror and vote and shout it down.
Exactly and spot on. That is the message, loud and clear...and now we must stand against it.
Strange “Jews,” these Emmanuels.
Have them simply Google Ezekiel Emanuel and read them for themselves. He has not tried to hide it.
How about showing the source of the quote from Dr. Ezekiel Emanuel?
We need it for ammo.
BTT
bttt
>>GUILLOTINE ! ! !
But the masters want the village burned down. Reconstruction is so, profitable.
Thus, rather than complying with their intent I think we should destroy them from within - by confronting every government employee worker-bee with the purpose of American governance: “TO SECURE THESE RIGHTS”.
Those employees whose scope of function is beyond that specified purpose, and who subsequently fail to seek a paycheck elsewhere, should be identified, exposed, and symbolically tarred and feathered on the Internet; hounded mercilessly until they develop an American conscience and stop suckling from the government tit.
Just as, under the protection of the 1st amendment Larry Flynt published an “A$$hole of the month”, so FR should publish a Bureaucratic Parasite of the week.
It’s time to put the teeth back in the watchdog (media); and we are it.
Here is the source for the “Complete Lives System”
http://www.ncpa.org/pdfs/PIIS0140673609601379.pdf
Here's some of the verbiage regarding what they want to decide for all of us.
Prognosis or life-yearsLeast curriptable? Really? Says who? It would be the MOST corruptable by the few who would have absolute control of it and the mechansim that decided life and death for the rest of us.
Rather than saving the most lives, prognosis allocation aims to save the most life-years. This strategy has been used in disaster triage and penicillin allocation, and motivates the exclusion of people with poor prognoses from organ transplantation waiting lists.7,21,46 Maximising life-years has intuitive appeal. Living more years is valuable, so saving more years also seems valuable.8However, even supporters of prognosis-based allocation acknowledge its inability to consider distribution as well as quantity.46 Making a well-off person slightly better off rather than slightly improving a worse-off person’s life would be unjust; likewise, why give an extra year to a person who has lived for many when it could be given to someone who would otherwise die having had few?8,47 Similarly, giving a few life-years to many diff ers from giving many life-years to a few.8 As with the principle of saving the most lives, prognosis is undeniably relevant but insuffi cient alone.
Promoting and rewarding social usefulness
Unlike the previous values, social value cannot direct allocation on its own.20 Rather, social value allocation prioritises specifi c individuals to enable them to promote other important values, or rewards them for having promoted these values.In view of the multiplicity of reasonable values in society and in view of what is at stake, social value allocation must not legislate socially conventional, mainstream values.1 When Seattle’s dialysis policy favoured parents and church-goers, it was criticised: “The Pacific Northwest is no place for a Henry David Thoreau with kidney failure.”48 Allocators must also avoid directing interventions earmarked for health needs to those not relevant to the health problem at hand, which covertly exacerbates scarcity.8,49 For instance, funeral directors might be essential to preserving health in an infl uenza pandemic, but not during a shortage of intensive-care beds.
Instrumental value
Instrumental value allocation prioritises specifi c individuals to enable or encourage future usefulness. Guidelines that prioritise workers producing infl uenza vaccine exemplify instrumental value allocation to save the most lives.5 Responsibility-based allocation—eg, allocation to people who agree to improve their health and thus use fewer resources—also represents instrumental value allocation.50This approach is necessarily insuffi cient, because it derives its appeal from promoting other values, such as saving more lives: “all whose continued existence is clearly required so that others might live have a good claim to priority”.20 Prioritising essential health-care staff does not treat them as counting for more in themselves, but rather prioritises them to benefi t others. Instrumental value allocation thus arguably recognises the moral importance of each person, even those not instrumentally valuable.
Student military deferments have shown that instrumental value allocation can encourage abuse of the system.51 People also disagree about usefulness: is saving all legislators necessary in an infl uenza pandemic?20 Decisions on usefulness can involve complicated and demeaning inquiries.52 However, where a specifi c person is genuinely indispensable in promoting morally relevant principles, instrumental value allocation can be appropriate.
Reciprocity
Reciprocity allocation is backward-looking, rewarding past usefulness or sacrifi ce. As such, many describe this allocative principle as desert or rectifi catory justice, rather than reciprocity. For important health-related values, reciprocity might involve preferential allocation to past organ donors,8 to participants in vaccine research who assumed risk for others’ benefi t,53 or to people who made healthy lifestyle choices that reduced their need for resources.50 Priority to military veterans embodies reciprocity for promoting non-health values.54Proponents claim that “justice as reciprocity calls for providing something in return for contributions that people have made”.53 Reciprocity might also be relevant when people are conscripted into risky tasks. For instance, nurses required to care for contagious patients could deserve reciprocity, especially if they did not volunteer. Reciprocity allocation, like instrumental value allocation, might potentially require time-consuming, intrusive, and demeaning inquiries, such as investigating whether a person adhered to a healthy lifestyle.5
Furthermore, unlike instrumental value, reciprocity does not have the future-directed appeal of promoting important health values. Ultimately, the appropriateness of allocation based on reciprocity seems to depend in a complex way on several factors, such as seriousness of sacrifi ce and irreplaceability. For instance, former organ donors seem to deserve reciprocity since they make a serious sacrifi ce and since there is no surplus of organ donors. By contrast, laboratory staff who serve as vaccine production workers do not incur serious risk nor are they irreplaceable, so reciprocity seems less appropriate for them.
Quality-adjusted life-years
Allocation systems based on quality-adjusted life-years (QALY) have two parts (table 2). One is an outcome measure that considers the quality of life-years. As an example, the quality-of-life measure used by the UK National Health Service rates moderate mobility impairment as 0·85 times perfect health.66 QALY allocation therefore equates 8·5 years in perfect health to 10 years with moderately impaired mobility.67 The other part of QALY allocation is a maximising assumption: that justice requires total QALYs to be maximised without consideration of their distribution.46,68 QALY allocation initially constituted the basis for Oregon’s Medicaid coverage initiative, and is currently used by the UK’s National Institute for Health and Clinical Excellence (NICE).69,70 Both the ethics and effi cacy of QALY allocation have been substantially discussed.46The QALY outcome measure has problems. Even if a life-year in which a person has impaired mobility is worse than a healthy life-year, someone adapted to wheelchair use might reasonably value an additional life-year in a wheelchair as much as a non-disabled person would value an additional life-year without disability.71 Allocators have struggled with this issue.72
More importantly, maximising the number of QALYs is an insuffi cient basis for allocation. Although QALY advocates appeal to the idea that all QALYs are equal, people, not QALYs, deserve equal treatment.73 Treatment of a serious disease such as appendicitis gives a few people many more QALYs, whereas treatment of a minor problem like uncapped teeth gives many people a few more QALYs.70 Even though the two strategies produce equal numbers of QALYs, they treat individuals very diff erently.8 Likewise, giving QALYs to someone who has had few life-years diff ers morally from giving them to someone who has already had many.8,47 Ultimately, QALY allocation systems do not recognise many morally relevant values—such as treating people equally, giving priority to the worst-off , and saving the most lives—and are therefore insuffi cient for just allocation.
Disability-adjusted life-years
WHO endorses the system of disability-adjusted life-year (DALY) allocation (table 2).74 As with QALY allocation, DALY allocation does not consider interpersonal distribution. DALY systems also incorporate quality-of-life factors—for instance, they equate a life-year with blindness to roughly 0·6 healthy life-years.74 Additionally, DALY allocation ranks each life-year with the age of the person as a modifi er: “The well-being of some age groups, we argue, is instrumental in making society fl ourish; therefore collectively we may be more concerned with improving health status for individuals in these age groups.”74 This argument, although used to justify age-weighting, would equally justify counting the life-years of economically productive people and those caring for others for more. DALY allocation wrongly incorporates age into the outcome measure, claiming that a year for a younger person is in itself more valuable. Priority for young people is better justifi ed on grounds of distributive justice.41 Also, the use of instrumental value to justify DALY allocation resembles that used in Seattle’s dialysis allocation, which inappropriately favoured wage earners and carers of dependants.The complete lives system
Because none of the currently used systems satisfy all ethical requirements for just allocation, we propose an alternative: the complete lives system. This system incorporates fi ve principles (table 2): youngest-fi rst, prognosis, save the most lives, lottery, and instrumental value.5 As such, it prioritises younger people who have not yet lived a complete life and will be unlikely to do so without aid. Many thinkers have accepted complete lives as the appropriate focus of distributive justice: “individual human lives, rather than individual experiences, [are] the units over which any distributive principle should operate.”1,75,76 Although there are important diff erences between these thinkers, they share a core commitment to consider entire lives rather than events or episodes, which is also the defi ning feature of the complete lives system. Consideration of the importance of complete lives also supports modifying the youngest-fi rst principle by prioritising adolescents and young adults over infants (fi gure). Adolescents have received substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments. Similarly, adolescence brings with it a developed personality capable of forming and valuing long-term plans whose fulfi lment requires a complete life.77 As the legal philosopher Ronald Dworkin argues, “It is terrible when an infant dies, but worse, most people think, when a three-year-old child dies and worse still when an adolescent does”;78 this argument is supported by empirical surveys.41,79 Importantly, the prioritisation of adolescents and young adults considers the social and personal investment that people are morally entitled to have received at a particular age, rather than accepting the results of an unjust status quo. Consequently, poor adolescents should be treated the same as wealthy ones, even though they may have received less investment owing to social injustice.The complete lives system also considers prognosis, since its aim is to achieve complete lives. A young person with a poor prognosis has had few life-years but lacks the potential to live a complete life. Considering prognosis forestalls the concern that disproportionately large amounts of resources will be directed to young people with poor prognoses.42 When the worst-off can benefi t only slightly while better-off people could benefi t greatly, allocating to the better-off is often justifi able.1,30 Some small benefi ts, such as a few weeks of life, might also be intrinsically insignifi cant when compared with large benefi ts.8
Saving the most lives is also included in this system because enabling more people to live complete lives is better than enabling fewer.8,44 In a public health emergency, instrumental value could also be included to enable more people to live complete lives. Lotteries could be used when making choices between roughly equal recipients, and also potentially to ensure that no individual—irrespective of age or prognosis—is seen as beyond saving.34,80 Thus, the complete lives system is complete in another way: it incorporates each morally relevant simple principle. When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated (fi gure).78 It therefore superfi cially resembles the proposal made by DALY advocates; however, the complete lives system justifi es preference to younger people because of priority to the worst-off rather than instrumental value. Additionally, the complete lives system assumes that, although life-years are equally valuable to all, justice requires the fair distribution of them. Conversely, DALY allocation treats life-years given to elderly or disabled people as objectively less valuable.
Finally, the complete lives system is least vulnerable to corruption. Age can be established quickly and accurately from identity documents. Prognosis allocation encourages physicians to improve patients’ health, unlike the perverse incentives to sicken patients or misrepresent health that the sickest-fi rst allocation creates.
Oops, I should have read the thread.
See my post 38.
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