Health Blog

I Want to be a Death Panelist

The “debate” was ridiculous, but the idea is fantastic.

September 17, 2009
Call it what you want, but death panels already exist in some form. [Credit: bensutherland and donabelandewen, compiled by Dave Levitan]
Call it what you want, but death panels already exist in some form. [Credit: bensutherland and donabelandewen, compiled by Dave Levitan]

I am considering dressing up as a death panel for Halloween. Well, I considered it briefly, until I decided that the costume wouldn’t work very well. It’s been on my mind a lot lately, as I monitored the crazy town hall scenes in August, the conservative propaganda from members of Congress, and finally the “you lie”-tinted speech that President Obama delivered last week.

And here’s why it’s been on my mind: it’s not a terrible idea. Look, I’m 100 percent behind Obama’s push for health care reform, although I would much prefer a MUCH stronger public option, maybe just a complete overhaul that nationalizes the entire system and turns us into a better-functioning version of Canada (I am aware this is impossible). What interests me is that people get so caught up in the idea of “rationing” health care, and that no one—be it doctors, policy makers, other experts, anyone—should be allowed to decide whether an 84-year-old with terminal kidney cancer is worth less money in health care costs than a 24-year-old with lymphoma or some chronic and expensive-to-treat disease. This is obvious to me, but say it out loud—“Spend more on the 24-year-old!”—and suddenly you’ve convened a death panel. Sorry, a Death Panel.

The actual use of that term, or whatever it was Palin meant by it, has been completely debunked a thousand times by now, but she managed to get it into the discussion. Her message, though, that all life is completely equal and no one should be denied a certain treatment because they have less value to society or something, is preposterous. If we remove the word “rationing,” we realize it happens all the time. On an acute level, it’s called triage. I cut my finger so badly a few weeks ago that it simply would not stop bleeding no matter what I did, so I went to the emergency room and sat there until 4:30 AM until a doctor came and put two stitches in it. I waited four hours because my finger wasn’t as important as any number of other things going on in that ER. That’s a small example of health care rationing. The resources available were used in a way that fit the situation. The terror!

On a much larger scale, the entire system is set up to ration health care. Your insurance costs differ depending on your age, risk factors, everything. Thus, certain people are deemed more worthy of receiving care than others. The way it works now, the only thing that factors in is how much it costs to treat those people (rather than, say, their value to society). So why not just take it a step further, make more use of tools like quality-adjusted life years (QALYs) and start spending money in logical, productive ways? I hereby volunteer to be President Obama’s first Death Panelist. And I don’t even need a Halloween costume to do it.

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1 Comment

Anna says:

I’m left to wonder just how a persons ‘value to society’ would be determined in that type of arrangement. How would you decide who is worthy and who isn’t? Should we single out everyone over the age of 70, 80 just because they are aged and may not appear to have much left to contribute? Or perhaps we should single out people with disabilities, someone with down’s syndrome for instance or Spina Bifida because they will always require those special services and the financial burden which would be considerable?

Everyone has differing opinions on what they consider to be valuable in society. If you start making health care decisions based on whether or not you feel someone is worthy of that care, then you leave the door wide open for broad interpretations and things like euthanasia for various groups not deemed fit enough to live.

What if that 24 year old you saved, later turned out to be a child murderer. Would you still think that life was worth saving over the 84 year old who still may have had a lot to bring to the community?

The problem is, not everyone places the same value on things. And when you have a society based on as much diversity as our own, then the opinions and values we place on one’s life and health are just as diverse as the groups we live in.

There was a time when persons with mental health issues or intellectual disabilities, for instance, were shunned by society and locked away for their entire lives because we mistakenly believed they were a burden with absolutely no value as a person. We were wrong then, and it would be just as wrong now, not to withhold treatment just because we perceived a person to be less worthy than someone else.

Everyone should receive care, regardless of who they are.

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