Ezekiel Emanuel and his charnel house

Ezekiel Emanuel’s infamous advocacy of death panels, under color of a "complete lives ethical system," results in a decision curve that the death panel would likely have in mind as they decide our health care rationing choices. Here is the lone figure from a recent article by Emanuel in the British journal The Lancet. It is a decision curve for the death panel, displaying their age-based priority for receiving scarce medical interventions under the complete lives system.

Dworkin's curve.  Click image to view full size.

Dworkin's curve. Click image to view full size.

● We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles…

● Rather than saving the most lives, prognosis allocation aims to save the most life-years. This strategy has been used in disaster triage…

● We consider several important objections to the complete lives system.

The complete lives system discriminates against older people. Age-based allocation is ageism. Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. 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…

article summary and subscription link to The Lancet
Figure, cf. RM Dworkin, Life’s dominion, Knopf (1993).

Back-of-the-envelope estimate of national health cost per age group

Back-of-the-envelope estimate of national health cost per age group

What the authors, Ezekiel Emanuel, Alan Wertheimer and Govind Persad leave out of their article is a curve that expresses the relative fraction of the national health care bill that each age group generates. It might look something like this back-of-the-envelope estimate (at left). We all know that a large fraction of health care costs go to helping our seasoned citizens …perhaps not 65% as shown but still a relatively large percentage.

This large percentage is what the complete lives system targets for elimination. This curve is what motivates the intellectual gymnastics of the complete life rationing system, and it will surely be on the table at the meeting of each death panel convened by the Health Choices Commissioner, which will use both curves to decide which health care choice you get.

The Emanuel article claims as an advantage his "intuition that death of adolescents is worse than that of infants or elderly."

That is the intuition of a charnel house.

I do not consent to that intuition. I am a humanist, advocating the incomparable value of every human person.

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One response to “Ezekiel Emanuel and his charnel house

  1. Pingback: Matt’s meditation on banality of evil men. « X Contra

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