Sunday, August 23, 2009

James Sabin, "Medical Ethicist," As The Grim Reaper. And John J. Pitney Jr., In Defense of Life.

Writing in Politico, Jeanne Cummings illustrates the wide gap between the thinking of the "health care policy" elite and the average American.

Perhaps Cummings didn't set out to let a leading "ethicist" hang himself with his own words, but that's what she did. Cummings reported on the question --a question for "medical ethicists," at least--of whether Sen. Edward Kennedy is getting too much medical treatment in his battle with brain cancer. It seems that James Sabin, a professor at Harvard Medical School and "director of ethics at Harvard Pilgrim Health Care" thinks that Kennedy should show "leadership" and die quickly and quietly and cheaply. Here's an excerpt of Cummings' story:

So, while not critiquing the specifics of Kennedy’s treatment, some medical ethicists said his case shines the light on the cost-versus-benefit questions that need more honest discussion by voters and politicians.

“What messages are being sent by the behavior of people in leadership positions?” said Harvard ethicist James Sabin, speaking of Kennedy.

Sabin recalled the powerful impact on the economic debate of Warren Buffet, one of the wealthiest men in the world, who declared publicly that he ought to pay more in taxes. “If Kennedy spoke of health care choices in the same way, it would be more than mouthing off,” said Sabin, a Harvard Medical School clinical professor and director of ethics at Harvard Pilgrim Health Care.

Given that about a third of Medicare dollars are spent on patients in the twilight of life, Sabin and other experts say a rethinking of treatment for them is essential to reducing costs in the system – a major goal of reform.

The medical choices of the man who has become the face of the universal coverage movement are a delicate subject, particularly with Kennedy’s own health so precarious.

This is, indeed, a delicate subject for liberals, because they know that a) the Kennedy family can afford the best treatment, and will spend what it takes; and b) the Democrats need Kennedy's vote in the Senate to ram through a plan. But even so, Sabin, the "ethicist," can't resist weighing in on the Kennedy case, arguing that Kennedy should go quickly. It would seem that "medical ethicists" can't resist opining, even in cases where their political interests would be better served by keeping quiet.

John J. Pitney, Jr., the Roy P. Crocker Professor of American Politics at Claremont McKenna College, gave SMS this sharp response:

Sabin's message is that Ted Kennedy should pass up life-prolonging treatment and go gently into that good night. The ethicist would applaud if he gave a farewell speech saying "I should die more quickly!" But Americans admire the Kennedys because they fight like hell against illness and injury.

The comparison to Buffet is nonsense. If Buffet gets his way and pays more tax, he's still a billionaire. If Kennedy pulls his own plug, he's dead.

This is the ethics of redistribution applied to life and death. This is the world of Sophie's Choices and overcrowded lifeboats. It's not the world Americans want to live in.

And that's pretty much that. The James Sabins might rule the roost at Harvard, and at "medical ethics" departments and centers and foundations across the country, but the American people reject such cold utilitarian calculus. (And of course, as noted here, "medical ethicists" have a way of changing their mind when it's their own life on the line.) Fortunately, we also have a few Jack Pitneys in the academy, as well, to foster a debate, if not exactly balance.

If the health elites want to continue leading, they should focus on curing brain cancer, not figuring out how to push us toward a convenient death.

1 comment:

  1. And this is exactly the problem with the whole QALY analysis. Ted Kennedy could potentially still post tremendous achievements, from a liberal point of view, in the final months of his life when the same liberals would write him off.

    Meanwhile, someone much younger (like me) could be a waste of space for years. Who is to judge what an extra year or even a day of life is worth?