Dr. Atul Gawande, a surgeon at Brigham and Women’s Hospital, is quoted in the Boston Herald celebrating a consensus reached in his state:
Massachusetts is really leading the way on this. It led the way on universal health care, on gay marriage, and it’s leading the way on this, too.
The two named successes were in politics superseding common sense and the desires of the customer (here called the “patient” for some reason). The people reaching the consensus are a coalition of four large teaching hospitals.
The issue on which they have now reached consensus, they call “quality of life.” No, that is a slogan on which they reached consensus. The issue is euthanasia.
“Death is not a failure,” reads the headline of this Herald op-ed, though most customers do not see the doctor for help dying but for help avoiding dying. “Medical students will be required to have conversations with people about breaking difficult news, prognosis and end-of-life planning.” No one can object to conversations, but when tin gods get to pick the “people” with whom one is required to converse, the result is not conversations but advocacy. Perhaps, in time, customers (patients) “will be required to have conversations” with the doctor about how comfortable death can be, compared to the awkwardness of imposing all that cost on the government budget to keep you alive. “It’s an important shift, [Gawande] said, from the fix-it mentality that many doctors are taught to possess.”
At the end of this road — the Massachusetts road, in which the doctor does not serve his customer (patient) but serves society by performing enlightened herd management (including culling the weak and infirm) — is Denmark, which triumphantly announced that it had eradicated Down’s Syndrome by simply aborting all who suffered from it. This is the road of blurring reality by holding that “health” is something that pertains to society and not the paying customer (patient). Ah, but he is rarely paying, these days.
Assuming death is the only option and studying how to maximize quality is a gigantic false choice, inevitable when the customer (patient) is not the one making the choices. This is the real, gigantic risk of making the government the paying customer.