Zeke Emanuel’s “Thinking Has Evolved” on End of Life Care, “Except in a Few Cases.”

We previously reported on Ezekiel Emanuel’s views on health care rationing. Now comes this from the Washington Times:

Emanuel said, “When I began working in the health policy area about 20 years ago… I thought we would definitely have to ration care, that there was a need to make a decision and deny people care…  I’ve come to the conclusion that in our system we are spending way more money than we need to, a lot of it on unnecessary care.  If we got rid of that care we would have absolutely no reason to even consider rationing except in a few cases.”

Comments (5)

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  1. Devon Herrick says:

    Section 1233 of the House bill would reimburse physicians for advance care planning consultations with any Medicare beneficiary. Some doctors who providing end-of-life counseling see a benefit to the current controversy.

    “Dr. Ted Epperly, president of the American Academy of Family Physicians, describes such conversations as sensitive and time-consuming since they delve into the “nitty gritty” details: whether patients want to use ventilators to breathe, defibrillation to restart their hearts or feeding tubes for nourishment. He says the discussions are best done with a trusted physician who has developed a relationship with the patients.”

  2. Devon Herrick says:

    Zeke Emanuel isn’t the only official backtracking. The Senate will eliminate end-of-life provisions due to the furor over whether the provisions could lead to encourage euthanasia.

  3. Ken says:

    I don’t think Zeke’s thinking has evolved at all.

  4. Neil H. says:

    Agree with Ken.

  5. Linda Gorman says:

    There are numerous issues in end-of-life “care” and the effort to push advance directives on an unsuspecting populace which are neglected in the current debate, one in which proponents cast the debate as ending pain and suffering for terminally ill elderly people.

    Not considering the other will end up legalizing murder by medical authority. Many of these aspects were cast into high relief by the Terri Schiavo case. At the time, the Association of American Physicians and Surgeons had some illuminating discussions of some of the nitty-gritty issues that are currently being glossed over.

    Some examples: are you consenting to withholding of food or water for the purpose of ending your life? Does it matter if you can eat if someone holds a spoon for you? How is this different than a feeding tube? Does the duration of helplessness matter? Is a feeding tube more high tech than insulin for a diabetic? If so, why is it ok to withhold a feeding tube but not insulin? If you can’t see a bright line difference than anyone with a chronic illness could, ultimately, be denied medical care.

    A woman in a nursing home has an advance directive saying no unusual attempts should be made to revive her. She is given the wrong meds. Reversing the lethal effects would require a trip to the ER. The nursing home points to the advance directive and doesn’t take her. She dies. A proper use of the advance directive or not?

    Someone has been in a car crash, suffered massive trauma, has had a limb amputated, and repeatedly begs his wife and his doctors to let him die. Should his wishes be honored? Should his wishes be honored immediately? After all, this would save society hundreds of thousands in trauma and rehab costs and his chances are poor anyway.

    If you vote for honoring this person’s wishes, you’d have killed someone I know who, a decade or so later, thoroughly enjoys life and has no wish to die.

    His first child is adding considerably to that enjoyment.