House Health Care Bill Gives Doctors Financial Incentive to Push Euthanasia
by Steven Ertelt
LifeNews.com Editor
August 10, 2009
Washington, DC (LifeNews.com) — To hear backers of the government-run health care bill tell the story, pro-life advocates are making up wild-eyed claims about how the measure will push euthanasia. However, one leading bioethicist and a Washington Post Editorial Writer say the bill does give doctors financial incentive to push it.
At issue is Section 1233 of HR 3200, the government-run health care plan that the House will consider when it returns from its August recess.
The measure would pay physicians to give Medicare patients end-of-life counseling every five years or sooner if the patient has a terminal diagnosis.
While pro-life advocates say the section opens the door to physicians pushing euthanasia or withdrawal of lifesaving medical treatment, or even basic food and water, backers of the bill call the claims rubbish.
Charles Lane, a member of the editorial board of the liberal Washington Post newspaper, admits in a Saturday column that at least some of the concerns are well-founded.
"As I read it, Section 1233 is not totally innocuous," Lane writes, adding that it "addresses compassionate goals in disconcerting proximity to fiscal ones."
"Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite ‘purely voluntary,’" as backers of the bill assert, Lane adds. "To me, ‘purely voluntary’ means ‘not unless the patient requests one.’ Section 1233, however, lets doctors initiate the chat and gives them an incentive — money — to do so. Indeed, that’s an incentive to insist."
"Patients may refuse without penalty, but many will bow to white-coated authority. Once they’re in the meeting, the bill does permit ‘formulation’ of a plug-pulling order right then and there," Lane explains.
"What’s more, Section 1233 dictates, at some length, the content of the consultation," Lane continues.
He points out the legislation says the doctor "shall" discuss "advanced care planning, including key questions and considerations, important steps, and suggested people to talk to"; "an explanation of . . . living wills and durable powers of attorney, and their uses" even though those are legal and not medical papers. The physician "shall" present "a list of national and State-specific resources to assist consumers and their families."
"Admittedly, this script is vague and possibly unenforceable," Lane writes. "What are "key questions"? Who belongs on ‘a list’ of helpful ‘resources?’ The Roman Catholic Church? Jack Kevorkian?"
Ultimately, the Post editorial writer says "Section 1233 goes beyond facilitating doctor input to preferring it. Indeed, the measure would have an interested party — the government — recruit doctors to sell the elderly on living wills, hospice care and their associated providers, professions and organizations."
"You don’t have to be a right-wing wacko to question that approach," he concludes.
Bioethicist Frank Beckwith notes Lane’s analysis in comments of his own that appeared on the blog of the publication First Things.
"Supporters of H.R. 3200 claim that its end of life counseling provision, section 1233, is merely voluntary for the patient," Beckwith explains.
"But a closer look shows that section 1233 includes conditions and financial incentives for physicians and other health care providers that create a setting in which an elderly patient’s decision to appropriate this option is likely to be less than voluntary," he writes.
Beckwith says anyone with elderly parents should be "deeply concerned" about the section.
"If, let’s say, H.R. 3200 or something close to it were to become law and the public option pushes private insurance into near non-existence (as would surely happen with all the incentives in place), then there will no neighboring state to which to run," he says. "You won’t be able to take your business elsewhere, since there will be no elsewhere."
"And to whom will you issue your grievance, a special ‘health court,’" Beckwith asks.
Such a court, he says, would be "one likely informed by a youth-worshipping culture and a utilitarian bioethics philosophy that sees the elderly (not to mention, handicapped infants) as burdens that are siphoning away valuable resources that could be put to better use in support of society’s “real persons” and more productive contributors."
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