Dr. Ezekial Emanuel–Putting Seniors And Infants Last

by Pup on July 30, 2009

The person who is perhaps going to end up with the most to say about your “allocation” of health resources if Obamacare passes is Dr. Ezekial Emanuel.  Yes, that Emanuel, Raum’s brother.  He is also a health-policy advisor in the Office of Management and Budget.

There’s something important you should know about him.  I will provide several links to more information on him, but I want to focus on his “complete lives system” which he has written about as recently as January 2009, in The Lancet, a well-known and respected medical journal.

The paper appearing in The Lancet is titled “Principles for allocation of scarce medical interventions” and discusses existing methods for determining who gets priority in allocation of limited and scarce medical resources, such as, who gets an organ, who gets the ICU bed, and who gets a vaccine which may be in limited supply.  He discusses why each of these are flawed for various reasons, and then proceeds to present his own alternative system–the complete lives system.

Dr. Emanuel’s complete lives system “prioritizes young people who have not yet lived a complete life..” and would be unlikely to without intervention.  Doesn’t sound too bad, does it?  Makes some sense, maybe?

Just wait.

He goes on.

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 fulfillment requires a complete life.

Emanuel then quotes a legal philosopher Ronald Dworkin, who said, “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.”  Emanuel comments that this argument is supported by empirical surveys.

So what?!  Some legal philosopher’s statement is not something to base medical decisions on.

We never know what any individual human is here for, what God’s plan is for that person, regardless of their age.

Besides all that, what “empirical surveys?”  Who did they survey?

Tell that to the first-time mother of a six-month-old who dies of SIDS.

So, in his system a teenager or young adult is more valuable, more worthy of receiving medical resources ( which will be in shorter supply) than infants or younger children.  I read the entire article, and can summarize it in six words:  elderly and infants are least important.

When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 get the most substantial chance, whereas the youngest and the oldest get chances that are attenuated.”

That means reduced.  But doesn’t “attenuated” sound so much better.

During his paragraphs which point out the advantages to his system over those currently used by Organ Sharing Networks and others, he touts his complete lives system as being “least vulnerable to corruption.  Age can be established quickly and accurately from identity documents.

Those pesky identity documents.

In his closing section he addresses objections that might be raised to his system.

The first objection that he expects would be raised would be charges of “ageism.”  His answer?

Treating 65-year-olds differently because of stereotypes or falsehoods would be ageist; treating them differently because they have already had more life-years is not.”

Well, good.  I’m glad he cleared that up.

These are the words of Dr. Ezekial Emanuel, brother to Raum, and special health-care policy advisor in Obama’s administration.  My suspicion?  He has been officially given a low-key position and title, but in actuality, is much more central than we know.  Again, that is only my opinion.

Remember:  15 to 40 years of age.  That’s the magic spot.

Guess I’m out of luck.  As are my parents, my siblings, most of my friends, and all the members of AARP.

Dr. Emanuel’s article in The Lancet

Here’s a great blog post from Freedom Eden, with additional links.  Dr. Emanuel has also stated that he thinks doctors take the Hippocratic Oath too seriously, and must change their way of thinking about their patients, and think more about social justice.  [Hat tip to Gateway Pundit]

Here’s a terrific post on a great blog I just found.  Rosita the Prole writes beautifully and has great information.  Be sure to read her “about me” page; she tells an enchanting American tale.

This post, from Watching the Nation, is a great source of info about HR 3200.  Written by my dear friend, Kathy will be writing a series on HR 3200 and what is in it.


{ 5 comments… read them below or add one }

Sneed Hearn July 30, 2009 at 9:27 pm

It’s time for a yeahbut. There is no clear path to a good answer but unless medical care is unlimited does there not have to be some allocation in effect as there is now based on ability to pay? This is CERTAINLY not to imply that the government is the entity that should be doing the allocating but pretending medical care is infinite and all should get ideal treatment is just naive; limits exist now and are inevitable. For that matter, if it is a true statistic, does it really make sense that 30% of a person’s medical expenses are incurred in the last year of life? The truth is that medical care is a limited resource and pretending otherwise is disingenuous.


Joseph July 31, 2009 at 12:16 pm

It’s funny how Liberals chant that “everyone has a right to healthcare”, yet with Obamacare, and Dr. Emanuel’s Complete Lives System, CONGRESS and other unknown, unnamed “doctors” are choosing who gets the healthcare. They will place priority on certain people, thus, in reality, choosing who gets the treatments necessary. Everyone has a right to healthcare, but only the ones that they deem worthy.


Conservative Pup July 31, 2009 at 3:50 pm

Sneed Hearn,
Appreciate your comment. You’re right in that at some point medical resources might have to be parceled out according to some system. However, I picture this happening in the case of some catastrophic event, whether man-made or a natural disaster of the greatest magnitude.

In a catastrophic event, there would probably be limiting and allocation of medical resources, but in an emergency this is called “triage.” All medical personnel are trained in triage, and practice “code black” drills annually at various places of employment. Sometimes an entire city will have one huge drill. Triage decisions are made by the medical staff on the scene.

This is different from what Dr. Emanuel was writing about in his article for the Lancet. I don’t recall that he ever qualified his position by stating that it was for emergency purposes only.

My point and position is that during non-emergency times medical care is available to all. You are mostly correct that the limiting factor is cost and ability to pay. But my point is that with the government-controlled healthcare they want for us, the “supply” of medical resources will decrease due to lack of private enterprise and the money that is currently made and spent on medical innovation. They will determine who gets what treatments all the time, not just during some major national emergency. This would just become the way of daily healthcare. I would rather have a free market health care system, where some treatments might be out of my financial reach, but at least possible–if I were to win the lottery–than to have a government-run healthcare system where those wonderful treatments just aren’t there for anybody anymore. Or, if they are, they are doled out according to some bureau’s “qualifying factors” with someone other than me or my doctor deciding if I qualify or not.


kathy July 31, 2009 at 4:19 pm

Yes, I believe Hitler and Stalin would be proud of this man’s thinking…control population, get rid of undesirables, etc, etc, ad nauseum.
But I too wonder about the availability of procedures that people cannot afford except for the very affluent. My husband and I purchase what we can afford, not what we wish we could have and that goes for health insurance too. We purchase a minimal plan that doesn’t pay for office visits because we can pay that. To this point we are in good health. If we needed treatment that we could not pay for, I am not sure that we would have it. This is a complex issue, but I am not ready to give any government bureaucrat control over it to decide who lives and who dies. I think it still needs to be in the hands of the individual.


Denny August 9, 2009 at 8:41 pm

The evil plans of the Democrat socialists must be stopped while still in Congress. To help defeat this attempt by the socialists to competely take-over America as we know it today through healthcare “reform,” I have written a blog entry on this very subject to alert my readers.

If we do not defeat them now, I believe it would be extremely difficult to reverse this coarse once it is put into law. I think the third largest employer in the world is the government-run healthcare system in the U.K.



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