The following is an article I wrote a while back, again hoping to be published. The piece give a glimpse into the thinking of the post-modern, so-called medical intellectual community regarding abortion and common ground. As you might imagine, the conclusions are anything but prolife. Enjoy the read.
The Enlightened View
Matt Anderson, MD*
An article published in the December 16th edition of the New England Journal of Medicine (NEJM) deserves comment as it provides insight into the thinking of the presumably-enlightened medical establishment. The NEJM may be the most widely know and respected medical journal in the world. Unfortunately, the journal has also never hesitated to engage in partisan political advocacy including the push for national health care.
Benjamin Corn, MD authors an article called Ending End-of-Life Phobia—A Prescription for Enlightened Health Care Reform in which he states Americans have a phobia of death. He decries the expense of end-of-life care which consumes a disproportionate concentration of expenditures. He views the “death panels” which were a part of the initial Health Care Reform Bill as a joke for late-night comedians, denigrating Sarah Palin for originating the phrase. He describes what he believes to be three unacceptable mechanisms doctors and patients use to face death—the use of hospital care at the end of life, gallows humor and deferred questions about death by patients.
He opines that facing death allows for healing of relationships, something a majority of folks don’t do apparently without his intervention. He states the health bill initially “permitted” Medicare payment to doctors for discussing end-of-life issues with Medicare patients, carefully avoiding mention of the mandatory nature of these encounters and the additional mandatory requirement for such a discussion any time a Medicare patient was admitted to a hospital. He calls these mandatory discussions a “cautious and reasonable approach.” He further states that patients avoid these discussions because they feel vulnerable and fear physicians are trying to save money by limiting services. He wants our society to achieve a level of maturity for end-of-life conversations. To achieve this maturity, these conversations would need to respect personal autonomy and the sanctity of life and also would need to develop a climate of balance. Dr. Corn would achieve this goal by arranging a meeting between the patient and a team of chaplains (to advocate for life) and medical experts (to advocate limited use of resources at life’s end).
He later asks questions about which reforms government health care should address, including “nuanced strategies” about medical futility, death with dignity and physician assisted suicide. By doing what he advocates, he states we may have truly comprehensive reform and better living.
On close examination, however, Dr. Corn’s advocacy is hardly enlightened and instead represents an ancient evil. Hastening someone’s death by denying care in the name of cost savings places physicians in the role of killer, a common problem before Hippocrates set doctors on the right path in 400BC with his marvelous life-respecting oath.
He contradicts his early angst about the cost of end-of-life care and need to save money by stating the lack of end-of-life discussions, for which he advocates, may be motivated by that very fear—less care to save money. The effect of a group of people meeting with a patient to discuss the cost of end-of-life care by doctors as opposed to the advocacy for life by a chaplain is disingenuous. Chaplains I have met in my medical career rarely advocated for life and generally felt euthanasia and cost savings were laudable goals. Such a meeting would not respect the sanctity of life.
That patients don’t discuss end-of-life issues with physicians is a condescending attitude implying doctors should be privy to intimate and private family interactions. Encouraging patients into meetings with doctors and chaplains as Dr. Corn advocates would make clear to patients they should reject available medical care and instead die. Such a group meeting could accurately be called a death panel.
Dr. Corn’s comments at the end of the article are revealing. Phrases such a “nuanced strategies” for medical futility, death with dignity and guidelines for physician-assisted suicide (a euphemism for euthanasia) illustrate his clear agenda. Deny care to save money. Subtlety coerce patients by committee. Condescend to patients. Denigrate politicians who accurately point out the effect of proposed laws. Encourage the very ill to reject hospital care. Consider euthanasia.
Patients have right to fear this enlightened approach.
*Dr. Anderson is a practicing obstetrician/gynecologist from Minnesota