Electing God 2
The Daily Mail describes how a mother unsuccessfully tried to get treatment for her newly born child only to be refused it by Britain’s NHS because the child was a few days under the limit set by government guidelines for intensive care.
Doctors left a premature baby to die because he was born two days too early, his devastated mother claimed yesterday. Sarah Capewell begged them to save her tiny son, who was born just 21 weeks and five days into her pregnancy – almost four months early. They ignored her pleas and allegedly told her they were following national guidelines that babies born before 22 weeks should not be given medical treatment. …
James Paget Hospital in Norfolk refused to comment on the case but said it was not responsible for setting the guidelines relating to premature births. A trust spokesman said: ‘Like other acute hospitals, we follow national guidance from the British Association of Perinatal Medicine regarding premature births.’
She [the mother] said: ‘When he was born, he put out his arms and legs and pushed himself over.
A midwife said he was breathing and had a strong heartbeat, and described him as a “little fighter”.
I kept asking for the doctors but the midwife said, “They won’t come and help, sweetie. Make the best of the time you have with him”.’
This may recall to mind the guidelines proposed by Dr. Zeke Emmanuel, Rahm’s brother, who is Barack Obama’s “Special Advisor for Health Policy”. In a paper entitled “Principles for allocation of scarce medical interventions”, he proposed the “complete lives system” which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated”. The baby described above got attenuated. A Belmont Club post on the subject reproduced this curve, found in Dr. Emmanuel’s study, showing the effect of this curve.
Plus, the Politico is reporting that: “Pelosi and Reid Tell President: We Have the Votes; President Wants Bill Passed Soon”.
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Evil. That’s the only way I can describe it.
As obvious as it should be to all what is in the heart of Obama I still find myself struggling to believe it’s all real and we have actually put this group in power. I’ve watched most of these stars trekking the political sky since I was a much younger man. There is now only one new one in the constellation but the alignment has caught me off gaurd. That said I’ve never felt more galvanized to fight it.
Not to be a jerk, but the most premature baby ever to survive was 21 weeks, 6 days– one day short of the NHS guideline. That’s what I could find on Google. Survival was not likely.
On the other hand, that baby was born in the USA.
Bohica: What did you do on Election Fay in November, 2008?
She should have claimed he was an illegal alien.
Bohica, what did you do on Election Day, in November, 2008?
John Lynch: I remember a time when anybody who knew anything would patiently explain to you that it was absolutely impossible for a human being to run a mile in less than 4 minutes.
What was the record for premature babies the day before the one you mention was born?
Apropos of the O’s big health care speech tomorrow night, here’s a link to Palin’s WSJ editorial, for those who haven’t read it yet:
http://online.wsj.com/article/SB10001424052970203440104574400581157986024.html?mod=googlenews_wsj
But _of course_ there won’t be any “death panels”, how silly.
There will, however, be a wilderness of “advisory boards”, “guidelines” from amorphous professional-sounding organizations, and “Special Advisors” who diffuse responsibility up and down the chain.
“Ve are chust followink orders, I mean, _guidelines_.”
Disgusting.
Larry Sheldon-
Yeah, we don’t know until we try.
The problem is when we are no longer paying for our own care. I think this mother would have mortgaged her entire life for her baby to have a chance. In the UK, she doesn’t have that choice.
Triage is an accepted practice when resources are scarce. Battlefield doctors are not supposed to waste time on the dying. The question is, given unoccupied resources, what is the point at which you don’t even try. When Michael Jackson died recently, the paramedics were said to have kept trying to revive him even when the chances of success, statistically speaking almost nil or effectively zero.
I think this incident goes to one of the core issues in the health care “reform” debate. A lot of the literature out there argues that while the US health care system provides high survival rates, the variation in rates is often a function of geography, economic status and race. In other words, the mean or average of the US outcome distribution may be relatively high, but the curve is relatively spread out. On the other hand, the NHS at least in certain cancers may have a relatively now average good outcome, but the variation is low. The curve is tight.
But that’s a feature for some, who feel they ought to be able to select their place on the curve; who may think that hard work, more money or more money spent on health care ought to buy them a better outcome than someone else. Being able to choose from a position in an spread out curve is to some extent a definition of choice and freedom.
Now in the case of this baby, some people would like the freedom to statistically waste their money. In other words, pay for the medical staff to try, even if the chances of success are small. But in a system in which average, standardized care is delivered, “guidelines” are inevitable. It’s just like going to the passport office and finding that your head is just 1/10 of an inch above or below a certain line and sorry, you need a new picture. Bureaucracy works that way. Some people are contented with that. And I suppose those sorts would like government health care. Others don’t. And that, I think, is in part what the debate is about.
And really, that is what Dr. Zeke Emmanuel’s curve is about. He’s looked at the data and figured that below and above a certain age, it isn’t “cost effective” to try. So in organizational terms, the system isn’t even going to try that much, since it’s a “waste” of resources. The issue, I think is this: if you pay your way, you will be treated as an individual. If you leave it government, you’ll be treated as a statistic.
There is also the “It won’t happen to me” component. A lot of people who support Obama care are in their 20′s and 30′s. Not too many in the 60′s range. I’m one of those people that Rahl wants to consign to a dark hallway somewhere.
This baby was not born in a MASH or front-line aid station.
I have read a couple of versions of this story and I don’t remember that any heroic ations where called for, just what we think of of as fairly routine care for a high-risk new-born.
An I for one would like to suggest that there is a Grand Canyon of difference between a decision made by the mother with the advice of her physician on the one hand and what is reported to have happened here.
One I approve of, the other makes us into soulless monsters, a thing that I absolutely disapprove of.
What a singularly appropriate nym, wretchard.
What this does, is create incentives that are not very good for society.
For example, bribery or threats or both to provide health care.
I.E., a woman gives birth to a premature baby. She has a family member beside her, is told no care will be given. The family member calls an organized crime figure, begging for help. Help arrives, in the form of “adjusters” who for a fee or service to named later, “adjust” that attitudes of the doctors and nurses.
Now, to who do ordinary people in these situations owe their allegiance to? While, neo-feudal lords of Organized Crime, that is who they owe their allegiance. Not the government, or nation, or bureaucrats who are the enemy, but feudal lords. Who protect not against Muslim or Viking raiders, or bandits, but against the predations of government.
If the government does not provide for the people, SOMEONE will. And eventually that someone might figure, might as well rule in name as well as fact. Dispense with the bureaucracy and rule as a King himself.
Enough of this stuff and people won’t sit passively by. Certainly not in places outside the UK (which is a lost, and dying people with “no future” having already arrived). It’s a recipe, or heck a guarantee, for intimidation, bribery, violence, anything to game the system to provide life rather than death.
How do you think medical progress is made? By trying to save babies like that. Even if not successful, the doctors and hospitals learn from the effort. Over time, the success rate of saving premies goes up, and the outcomes are better.
Socialized medicine will shut that down. Can’t do it, don’t even try. So no progress is made.
At one time, open heart surgery was expensive and not very successful. 40 years ago, we could have said, ‘why waste the money? The patient will probably die anyway.’ Now, however, open heart surgery is routine and highly successful.
This goes to the heart of the collectivists rationale: that there is a static unchanging amount of wealth (including medical care) and that we should redistribute it according to how the geniuses in charge tell us. They tell us not to waste it on pointless procedures. The collectivists live in a sad, dreary world, of limited possibilities and no opportunities.
I don’t want to live there.
Larry Sheldon,
Excellent point. The analysis of Dr Death Emanuel is not only morally repulsive when applied to a baby born in a hospital where there are resources available to attempt a treatment but it is also a static view of life. Socialist analysis is always zero sum, frozen and fails to consider the incentives or potential for improvement.
This following list went into moderation before. Let us see if WordPress does not like it again.
wretchard, Please delete my post in limbo. Thank you.
Attenuated
Rectified
Made Redundant
Recycled
Normalized
Economized
Resource Conserved
Deprioritized
Efficiency Adjusted
Rendered
Liquidated
Consumated
Filed
Congress should cite this case as reason to pass a law denying any physicians trained or licensed in the UK the right to have their credentials considered in the US and deny them Visa access as professionals.
The death of the baby is not the tragedy. Death probably was certain. The tragedy is that a doctor never saw the baby. No doctor assessed its chance. They were not to look.
Like many stories this one omits a vital fact. Was the birth at home or at the hospital? It seems to have been at the hospital.
Would there have been costs? Yes. Accountants could allocate costs and make that a very expensive baby indeed. But a number written on paper by an accountant is not the cost.
In reality the marginal cost would have been small because everything required was already in place, at hand.
One can imagine the chatter “Too bad. No one is to blame you see. After all it was the guidelines. And no one sets the guidelines, they are decided by someone, somewhere. Or maybe a machine sets them. And because they are guidelines they aren’t orders. Because if they were orders that would be interfering with the Doctor’s judgment, and we couldn’t do that.”
The doctors and associations who develop standards and guidelines have an impossible task. Be glad cases precisely on the cusp are so rare.
The comments so far have been spot on, but I still have not seen the one criticism that rankles the most: if that premature infant had been Harry Reid’s grandchild, or Pelosi’s, or Obama’s, it would have received extraordinary care. In other words, the people who make up the boards that decide who qualifies for treatment and who does not, are not subject to the same criteria. This is not just wrong, it is outrageous. Where is the outrage, voters? F
13. whiskey:
Even before I read of your example of organized crime, the thought that occurred to me was that people who are politically connected will get a higher level of care than those who aren’t. You call your friend in the government, he calls someone high up in the NHS, and presto!
So I guess that isn’t a whole lot different from organized crime after all. You just have to know which palms to grease.
F: I took it as given that the royalty is not bound by any of this (as I recall the draft was said to specifically exempt the royals–the puzzle to me was who is going to be left to provide the care?).
But I did think of it and saw no point in mentioning it. And as I suggest, it is a self-solving problem if they destroy the medical system as I think they will.
This and battle field triage comment bought to mind the James Caan scene in “A Bridge too Far”.
That also reminds me that this is about a social contract. Like the one we have with our soldiers. To do whatever it takes to leave no one behind. That “contract” is necessary, breaking it can break the armed forces and the nation.
So too is the “contract” inside families to do whatever can be done for those made helpless by disease, injury, or age. Break that, hand the job over to bean counters in a government agency and you shatter the family. But then that may be seen as a good thing by some pushing this horror on everyone.
“You call your friend in the government, he calls someone high up in the NHS, and presto!”
and “presto!” what?
Where will the doctor experienced with high-risk newborns come from?
Where will the equipment he or she might need be? When will it last have been used?
Why would money to have bought it or maintained it have been wasted?
It would be nice if people would think these things through.
One can imagine the chatter “Too bad. No one is to blame you see. After all it was the guidelines. And no one sets the guidelines, they are decided by someone, somewhere.”
Reminds me of Robert Jay Lifton’s observation in The Nazi Doctors: Medical Killing and the Psychology of Genocide, that the expansion of bureaucracy is a major factor in these horrors– because it makes killing (or withholding care, which can amount to the same thing) anonymous and faceless, therefore much easier psychologically on the killers (or the uncaring care providers). Bureaucracy also dilutes and eventually destroys a sense of personal responsibility, as the politicians who set policies aren’t the lower-level flunkies who have to carry them out. It’s a cut-rate way to sterilize the human conscience.
21. Larry Sheldon:
I have an extremely hard time believing that the elites have any intention of living by the same rules they make for us. At least the baby would be seen by a doctor, so it would have a better chance.
You do make some good points. Maybe they haven’t thought it through.
@ whiskey #13: “If the government does not provide for the people, SOMEONE will.”
Also likely is the “John Q” scenario described below, and variants thereupon, where people take the matter of denied medical care into their own hands:
http://www.imdb.com/title/tt0251160/plotsummary
“John Quincy Archibald’s son Michael collapses while playing baseball as a result of heart failure. John rushes Michael to a hospital emergency room where he is informed that Michael’s only hope is a transplant. Unfortunately, John’s insurance won’t cover his son’s transplant. Out of options, John Q. takes the emergency room staff and patients hostage until hospital doctors agree to do the transplant.”
Although the movie portrays a situation where insurance companies are the heavies, under a single payer plan wouldn’t government bureaucrats fit the role just as nicely?
If it were the premature birth of a baby born to a parlimentarian or a member of the royal family, do you think the child would have undergone the same parameters for life saving care?
No. A couple of phone calls would have had the entire staff going nuts to save the child. It’s who you know and where you stand.
Bureaucracy works that way. Some people are contented with that. And I suppose those sorts would like government health care. Others don’t. And that, I think, is in part what the debate is about.
Actually Wretchard, it’s more than that. Those who are content with the substandard smear of service that comes from a bureaucracy are not content at all with anyone else having better. That’s the real problem. They combine the sins of sloth and envy. Sloth in that they are unwilling to do what it takes to better their condition, and envy in that they hate those who do.
Very evil, wicked people. Bastards. Worthless, contemptible filth. This story is the ultimate expression of their world view. Let the baby die.
Obama lies, baby dies.
wretchard @ 10:
Very cogent. The ironic thing is the the Left see themselves as the compassionate ones and the Left sees the Right as the cold-blooded. But as you point out, reality does not quite square with their dreamtime.
We have rationing in this country already. Just wait until you or a loved one hits the Medicare/Medicaid rolls!
Should this Frankenstein monster of “health care/insurance reform” be passed look for big changes in the society.
Remember how the Media and the Left tried to paint G.W.H. Bush as a patrician completely out of touch with the burden of the common man when he expressed astonishment at a sophisticated new laser-scanner in a supermarket checkout.
The real point is how pathetically ignorant the media and – well, yes – ALL politicians are about the breathtaking rate of technological change in retail supermarkets. The fact is suburban supermarkets 20 years ago typically stocked over a hundred thousand different items. I mentioned that to a store manager a few months ago, and she said it was more like 400,000 (Four Hundred Thousand) separate items in her Kroger store.
I think the technology that keeps that system going is only rivaled by something like the NSA. No wonder Bush was impressed; I don’t believe any elected federal politician ever gazinta a supermarket after the first year in office.
I should edit better. But that is such a drag.
This “And no one sets the guidelines, they are decided by someone, somewhere.”
should read “And no one sets the guidelines, they are decided by a committee. Probably. Somewhere.”
The elites will always be with us. And they will always have privileges. There are many types of privilege but they divide roughly into power and knowledge. Or we might say powers and connections.
e.g. The Kennedy family has few formal powers (at the moment). But they have thousands of connections to useful people. In a way that has been is their life’s work since about 1930. They are the Corleone Family after three generations of Ivy League education and summers in Europe.
When John Kennedy Jr. crashed his airplane at sea US destroyers were sent on the search. Later, for no apparent reason he was buried at sea from a US destroyer. Connections? You bet.
ObamaCare will help or hurt only the masses. The elites have no dog in the fight and they know it. Only the strictest possible national health service would attract their attention. A nation where private medical care is outlawed and all facilities are nationalized and all medical personnel are employees.
The elites would then schedule care overseas whenever possible. And bribery, power, or connections would be the routine way to get better or faster care in the US.
Oh, wait. That was how the Soviet medical system ran.
The Canadian system outlaws private medicine for those things the state provides, BUT politicians in Ottawa and those who need immediate care to keep them in their ‘job’ eg. hockey players etc can pay for immediate action.
It rankles but I should not complain because, so far, the system has always come through for us, promptly enough and efficiently enough too.
Suppose this premature birth had occurred in the USA and the parents had only limited or no insurance, the hospital would have had to preface its offer of care with “Provided you can show us you have the means to pay . . . Then the howls would be “Hospital lets bay die for unpaid bill.”
It is the USA citizens who must choose, and by their election they appear to have done so.
ChrisVj: I hesitate to make generalities. But you are incorrect when you say:
“Suppose this premature birth had occurred in the USA and the parents had only limited or no insurance, the hospital would have had to preface its offer of care with “Provided you can show us you have the means to pay . .”
Fact: in the US the hospital and its staff would be legally obligated to do everything within their power to keep the baby alive. Money or no money.
Then the hospital could seek a transfer to another hospital when the baby’s condition permitted. The second hospital presumably being either tax supported or having better facilities for a specific condition.
The transfer would not be to a hospital unable to provide adequate care for the baby’s condition.
The US rule and laws say treat first, coordinate for better placement, then get the money where and when you can. And often you can’t.
That does not mean hospitals want or like to treat people who cannot pay. It does mean they can’t force them to locate another hospital unless they are capable of doing so.
Sometimes you hear of hospitals or other providers trying to do just that. Or in some other way evading their legal obligations. They will get in a lot of trouble. A lot.
What is the actual problem here?
It is not people going without medical care. The problem is that Medicare is going broke. And so is every other government program in the US. And virtually every state government program too. And the state governments themselves.
Besides the awkward fact that government is out of money our medical system has other problems.
The marginally ill and uninsured often hover in limbo awaiting events. They are not ill enough for hospital admission but they definitely have an affliction that medical care could alleviate. Because that is not treated, or treated well, the condition may worsen into an emergency. Then they get into a hospital. That is not a good sequence and a definite problem in our country.
But I must leave that and go to insurance.
The insurance situation has two major problems; previouly existing conditions, and cancellation.
A private health insurer usually won’t insure a pre-existing condition. No company can, great numbers of people needing hideously expensive treatments would rush to sign up. The company would quickly go broke.
The pre-existing problem produces heart-rendering stories in the media. But it is exactly analogous to a person seeking hurricane insurance while his house is flying apart or already gone. If insurance companies had to write such policies they would go broke or exit business.
And in the US many insurance companies do exactly that. They close operations in states where legal obligations make them lose money.
A problem akin to pre-existing is policy cancellation. I personally think a company should have to keep a policy in force provided the insured has not falsified the application or claims. Or exceeded policy limits. Since companies do not require a physical exam before issuing coverage they should have some limited period to challenge unusual claims. Perhaps 90 days from when the policy was issued.
Now. What is ObamaCare?
ObamaCare is still fog. But we know a little.
O has said companies must insure pre-existing conditions. And they may not cancel. Hey, that sounds really neat. You just make a law.
However those terms would destroy the insurance companies. So there must be more to the story…
And there is. Enter the much disputed Public Option. If no one else will insure you the Public Option government insurance will.
The PO is not to be free, there will be a premium. But if you can’t pay the government will pay your premiums.
The PO idea is worrisome because a government company will be competing with private companies. And face it, the government company isn’t going to play by the same rules. It will ruin the private companies if political restraints are not maintained.
ObamaCare has about 8000 pages of text and covers many other things. But I hope this is a fair outline of the health insurance problem and of the PO.
I repeat, the problem is we don’t have the money to meet our promises. And no sane person thinks our government is solving that problem. And if most probably think they are making it worse.
ChrisVJ: You are wrong.
In the USA, the expectation is for the doctors and all other medical professionals to perform lifesaving measures – even heroic ones – especially for premature births, until and unless the parents say no. The question of pay does not even come into it *at that point* – that is to say, the doctors will go to all lengths FIRST, and AFTERWARDS we can talk about money.
No hospital in the USA will simply kill you off or stop your supply of food/water because you cannot pay; those that do will face censure and condemnation. But under ObamaCare, this very scenario will play out millions of times.
the doctor made a crime, he isn’t respecting the medical deontology, where it is a duty to care for any human being born alive
Looking at the graph in the main post and the average age of the legislators is it any wonder that they turned it down – they obviously didn’t like the odds.
When President Harry Truman first proposed compulsory health insurance in 1949, he coupled his proposal with a big increase in federal aid to medical education. He grasped the fundamental reality that you cannot expand coverage without expanding the number of people who provide the service – unless you are prepared to resort to wholesale rationing….
Nowhere is the fallout from Obama’s healthcare proposals more evident than among the elderly….
They will not forget if the Democrats push through cuts in Medicare and then ask for their support in the next election. Their memories are long and they turn out in huge numbers. Until now, these traits have worked to the advantage of the Democrats. Now they are increasingly likely to deliver Congress and the White House to the Republicans.
Dick Morris
A couple of notes.
It is my opinion, healthcare & education (especially early education) are more vocations than professions. Interestingly enough, both were at one time dominated by the religious working for little or no pay.
Next, funny they need to extend that probability graph off to the negative years but then as demonstrated that is trivial as the probability appears to be zero.
Next, when talking of insurance I often use sports betting. For example, no one in their right minds would place a bet in the middle of the game when the score was 42-0. That is akin (as is noted – the hurricane insurance policy being placed on a house as it is flying apart) to covering already known conditions.
This sorta thing leads to those ridiculous TV stories about couples sandbagging their homes to prevent floodwaters from getting on their property for 48 hours (or however long) so the terms of the insurance policy are met. As soon as the wait period is over they let the waters come in and collect on the policy. That is in essence, paying off the players to throw the game.
Re the treatment the bigshots will get vs the rest of us: Years ago a patient of mine ruptured a disk in her neck causing severe pain and partial paralysis of her left arm, mainly the biceps. I called my favorite neurosurgeon in Big City to get her cared for. He called back shortly saying there were no beds available in the hospital.
I told her and she made a phone call. Soon after, I heard again from the neurosurgeon, saying in effect, “Well I don’t know what happened but all of a sudden there’s a bed so send her on up here.”
Her husband was our local state representative and, like all of us, he wanted his wife to be cared for. If Dr Emmanuel, et al will take the same medical plan as the rest of us I’ll accept anything they pass.
The bottom line in all this is; How do the policy-makers veiw the people? To a Socialist we are just “ants in the mound”. If you are lucky enough to be born healthy you will be brought up to speed and kept reasonably healthy while you are a productive (i.e. taxpaying) citizen, as soon as you retire (become a burden on the system) you are deprived of health-care (that way you will die off ASAP so as to lessen the expenditure of scarce reasources).
The real joke of the entire matter is there are no “scarce medical resources” aside from transplant organs. Modern manufacturing processes have driven down the price of the things that are part of medical care.
Modern legal systems have driven up the costs of the business of medicine to the point where every item has a built-in surcharge to cover the inevitable lawsuit. Doctors order redundant tests jsut to aviod legal complications down the road. Dozens of layers of this drive up costs to an astronomical degree.
Gonna say it one more time, then I’m going to give this group up as hopeless.
“It’s who you know and where you stand.”
If there are no medics around who are experienced in high-risk newborns, and if there is no equipment around because the expense was not justified, knowing God is about your only hope, knowing some pol is not going to help.
wretchard wrote:
“The issue, I think is this: if you pay your way, you will be treated as an individual. If you leave it government, you’ll be treated as a statistic.”
You seem to be missing (glossing over?) the current role that insurance companies play in the process. It generally is not the case that you simply reach into your pocket and pay for medical service. Instead you or your employer, pays the insurance company who then have their own panels, their own data, and determine what they shall or shall not pay for. Corporate run death panels. Joy, what Joy!
“We have rationing in this country already. Just wait until you or a loved one hits the Medicare/Medicaid rolls!”
I am 70+, my wife isw note far behind.
I have a number of ailments, my wife has had a number of surgeries (knees replaced, that sort of thing) and is a survivor so far of breast cancer.
It is hard to imagine how we could have better medical care.
And to tag that base early–we are not Anybody In Particular.
We just worked hard, put money away, managed our income, and our expenses (including insurance) on the assumption that we are responsible for us.
“We have rationing in this country already. Just wait until you or a loved one hits the Medicare/Medicaid rolls!”
I am 70+, my wife isw note far behind.
I have a number of ailments, my wife has had a number of surgeries (knees replaced, that sort of thing) and is a survivor so far of breast cancer.
It is hard to imagine how we could have better medical care.
And to tag that base early–we are not Anybody In Particular.
And I’ll point out that the Soviet system that favored the Important People collapsed. There is a reason why iut collapsed.
For extra credit, what was that reason?
We just worked hard, put money away, managed our income, and our expenses (including insurance) on the assumption that we are responsible for us.
Suppose this premature birth had occurred in the USA and the parents had only limited or no
insurance, the hospital would have had to preface its offer of care with “Provided you can
show us you have the means to pay . . . Then the howls would be “Hospital lets baby die
for unpaid bill.”
The signs in the hallways and waiting rooms of the University of Nebraska Medical Center suggest that that is simply not true.
[later edit] I wish I had read “K”s piece–a better making of my point. [later later edit] And so did Gregory! And I don’t know yet who else. Which seems to put me in the postion of “beating a dead horse”. Would that that would be true. Looking for a stake to drive through the heart is more like it.
I don’t have any first hand experience with not being able to take care of myself, but I do participate in several charities that provide help, and I believe my taxes help with the truly indigent.
I recall years ago walking to the train station every afternoon past a pan-handler and his dog. He was a pleasant guy with an entertaining spiel and line of patter.
He and his dog went missing for a while and I wondered what happened to him, but never found out.
Then one day he (and his dog) were back–I asked him where he had been.
He explained that he had gotten sick and had deliberately annoyed a cop (peed on his shoe, if I recall the story correctly). He had been taken to jail where he got a warm bath and a change of clothes, and then was taken to the hospital.
I’m sure there are people who fall through the cracks, but it is not the norm or the goal. Or at least it didn’t used to be.
By the way, sending destroyers on a search and rescue operation is fairly routine, I do believe.
And it is interesting that it is brought up in this discussion! I believe we have a significant presence in the Gulf of Mexico whose primary assignment is helping people escaping from Castro’s medical system.
Marie Claude writes: “the doctor made a crime, he isn’t respecting the medical deontology, where it is a duty to care for any human being born alive”
I am really unsure of my facts here, but based on the way the statistics are reported, I suspect that even if the law and the ethics where this happened say that, this child was not a person, and would not be until 6 months (or some such period) after birth.
I guess a way of looking at it is that where this happened, abortion is still legal long after anything even we are willing to abide.
I said I wasn’t going to mention this again but Gordon’s illustration of my point is too good to passup.
In his recitation of a string-pulling event, two thoughts came to mind.
One is that in that case there were trained and experienced doctor’s (and presumably equipment and staff) available–a bed was in short supply. That happens. (I have twice, I think, once for sure, had to stay in a recovery room after surgery because of a bed shortage–and both of those were scheduled surgeries.)
The other thing that occurred to me is that my wife and I on occasion have had to do the string-pulling (and we are certified Nobodies, and the people we called where not particularly special.
But the people called were staff bureaucrats (not medicos) (true both in the original refusal and in the followup correction) who don’t always have the patient’s (“customer’s”) best interest at heart. Phone calls or visits are sometimes necessary to apply a much needed clue-by-four to the problem.
Shit does happen–it is not a perfect world.
If you are a “the-world-owes-me-I’ll-sit-here-until-I-get-my-due” type you may not have as much fun.
But if you are in the habit of talking care of yourself and your loved ones, it is not a bad place.
And definitely better than any alternatives presently available of currently being promised for the future.
(anybody want to guess what time I went to bed last night and what time I got up this morning?
With all the attention focussed on the ability of the panels to decree that levels or degrees of care are, well, “inappropriate”, I’m curious — who is going to explain this to the trial lawyers, and who is going to insulate the hospitals and doctors and paramedics (full disclosure – I’m an EMT-I) from the lawsuit s**tstorms that typically rain down from decisions to withhold lifesaving or life-extending or life-benefitting care? Because if the law won’t do this, (and there is no sign that Congress has any intention of curbing the excesses of the plaintiffs’ bar) there won’t be any hospitals, doctors or paramedics to extend care to the favored 20-to-50 demographic — they’ll all be in court 365 days a year defending themselves from liabiity lawsuits full-time because multiple patients didn’t see eye to eye with a beneficent panel’s brilliant disposition of their cases.
Larry-
Yes, your care is adequate. But try being my now Sainted Mother. She had a debilitating stroke at around age 75. The next years brought us nothing but a pain. (Full disclosure – she was retired US Gov’t and had the good supplemental insurance.) Rehab services needed about every 2 years due to the progressive nature of stroke were always about 25% short of the duration needed. That was due to Medicare + Insurance not footing the bill for the extra due to their “rules and norms” when the professionals who wanted the extra and recommended it were ALWAYS shot down. Without notice.
I would ask to appeal and could, for care that was too late. So, it is my personal experience that tells me what is. You have just been lucky that your conditions were amenable to resolution. If it becomes degenerative, you are SOL. And I have had myriad hospital people tell me the same.
“Robohobo”–I missed where you mentioned her (and yours) provision for the thngs your insurance policies don’t cover.
I wish that my insurances covered the compression stockings I need, and the PT I need, but it doesn’t.
*shrug*
So we pay for it out of our savings, which is probably less than the increased insurance premiums or the taxes would have.
And I have some bad news for you Obamacare isn’t going to cover it either. The difference seems to be that under the New Plan it won’t be available at any price. (“New Plan” has a familiar ring–where have I see that before? Was that in “1984″?)
Human sacrifice to the gods of leisure and comfort. But the guilty continue to live on death row.
“Marie Claude wrote:
the doctor made a crime, he isn’t respecting the medical deontology, where it is a duty to care for any human being born alive”
I do not agree that this was a moral crime. It is not an ethical obligation to perform useless procedures on people where there is no reasonable chance that it will affect the outcome.
How do we know what is a ‘reasonable chance’? The answer is doctors are in the reasonable-chance-deciding business. This is not mathematics here. You get professional judgement because that is all there is to get.
To ‘care for’ is quite different than ‘doing everything on everybody’. Medicine operates on probabilities and judgements based on both objective and subjective data. It is quite clear that the prognosis here was effectively zero. There are limits where further intervention is mere self-serving cruelty.
The real issue here is the mother. It would have been important for her to really feel that she was doing all she could. If she was just given a brush-off then she would never be able to eliminate the doubt that this was somehow all her fault. Instead she transfers her feelings to the hospital, or the system. Kinda like some may unconciously do so to Obama or socialism when confronted with the unpleasent truth that a baby may be born alive yet be beyond the boundaries of medical science to save her.
No man is an island,
Entire of itself.
Each is a piece of the continent,
A part of the main.
If a clod be washed away by the sea,
Europe is the less.
As well as if a promontory were.
As well as if a manner of thine own
Or of thine friend’s were.
Each man’s death diminishes me,
For I am involved in mankind.
Therefore, send not to know
For whom the bell tolls,
It tolls for thee.
John Donne
“spindok” — one tiny flaw in your wonderfully comforting explanation.
As reported, the rules forbade a doctor from being involved.
I think we have covered all the useful discussion of this anti-human tragedy.
I’m out.
Well, if we give the best care only to those who possess the greatest social utility, I guess that means we can withhold food and water from almost everyone working for government, (except the military.)
“Amillia Taylor was born in Florida on October 24, 2006, after just 21 weeks and six days in the womb. She celebrated her second birthday last year.
Doctors believed she was a week older and so gave her intensive care, but later admitted she would not have received treatment if they had known her true age.”
I wonder if these doctors changed their processes now the Born Alive Infant Protection act is law.
“As reported, the rules forbade a doctor from being involved.”
Wrong. The article says the rules are guidelines.
If it had happened in a french or a german hospital, the doctors wouldn’t have set the dilemn, but only saving the baby would have been their main worry. Thus everone would have had the councience to have tried all they could.
Now, that are the medical cares I used to know, dunno if they have changed nowadays, I am fortunate enough to not need them up to now.
Not much to add. A couple things that might interest Sheldon.
As I recall there was a minor fuss about the destroyer diversions at the time JFK JR. crashed. And Clinton himself sent the orders.
That may be wrong. I usually don’t follow such stories and wouldn’t have cared one way or the other. So I will abide by the facts.
I think writing this:
“If there are no medics around who are experienced in high-risk newborns, and if there is no equipment around because the expense was not justified, knowing God is about your only hope, knowing some pol is not going to help.”
misses the point about influence:
Doctors were there. And if they weren’t experts in high-risk newborns that doesn’t matter. They certainly had some skills and could have assessed the baby’s condition. They wouldn’t.
No one on Earth would have expected the staff to magically employ skills they didn’t possess or to employ equipment they lacked. It was the refusal to assess that seems ominous. The baby had the wrong number.
A number, the conception date, wasn’t suitable and therefore no effort would be made, the baby was to die. That was in the book.
I tend to go easy on the system. Medicine can only do so much, society has limited resources to allocate to virtually unlimited problems. Whether we like it or not we are all in triage.
At the macro level medicine and politics decides when the medical efforts must end because the patient can not be helped with any treatment or with any reasonable amount of resources. (note the weasel word reasonable)
The baby was in that tier.
Similarly they decide what problems are so trivial that no care is needed.
i.e. “if you really want that then pay for it yourself.” medicine.
Breast implants and tummy tucks…..
And in between is where most of us spend about 70 years. And where repairs are occasionally needed, some quite substantial, and most effective.
Hernias, broken limbs, accidents, infectious diseases, child birth…..
Not to be argumentative, butr one thing I can do is read>
The DailyMail article says: “I kept asking for the doctors but the midwife said, “They won’t come and help, sweetie. Make the best of the time you have with him”.’”
The headline at http://www.dailymail.co.uk/news/article-1211950/Premature-baby-left-die-doctors-mother-gives-birth-just-days-22-week-care-limit.html says “‘Doctors told me it was against the rules to save my premature baby’”.
K: and maybe others–timing is relevant.
Yes, in the case that started this discussion there were doctors there who did not act.
If the reasons for their refusing to act continues for very long in the future there will come a time when there are no doctors who have ever acted.. If you should have the urgent need, and the political influence necessary, how fast can you find a buggy-whip maker? A four-barrel carburetor mechanic?
And that is what worries me (Well, “me” in a philosophical mood. At 70+ it isn’t going to matter to me much. I just hope the dark hall is warm.)
What astonishes me is the willingness of the utilitarian branch of progressivism (which is the mentality we are talking about here) to descend to the barbarism of our most primitive ancestors. I do mean our Paleolithic ancestors, who may have — based on observations of some hunter-gatherer groups in recorded times — had to make hard choices with elderly and infant tribe members. But even by the Neolithic, with more assured food supplies and shelter, the idea of deliberately “offing” the very young and the very old was starting to go out of fashion.
Why in the name of Creation would a modern, prosperous, civilized society feel a need to find the sick elderly and infants to be both inconvenient and too much of a challenge to be helped, and even cured? There is no moral or rational justification by any truly civilized standards. I also find it appalling that so many “bioethicists” belong to the utilitarian movement; it is disgraceful that they are allowed to have that title.
While it seems off-topic, there is a tenuous connection between the animal rights movement and utilitarian ideology. Peter Singer, the uber-utilitarian himself, is the spiritual father of animal rights, having written “Animal Liberation” in the 70′s. What most well-meaning, animal-loving people don’t realize (nor do animal rights activists’ most vociferous critics) is that the hard-core animal rightists are not trying to elevate animals to the same status of humans, but are trying to lower (debase) humans to the same status as other animals. Hence, the propensity of leftists to think of humans as just another form of cattle, to be husbanded like all the other herds. This gives a new twist and meaning to “Animal Farm,” doesn’t it?
Actually, Roderick Reilly, I think you are close–we humans have become, in there eyes, the occupants of the out-of-use category of “vermin”.
Critics of the US system often point out that our statistics of infant mortality are worse than those of other countries. In the present case, the death would certainly have been recorded as a stillbirth, and not as an instance of infant mortality. If the same thing had happened here, and the doctors had tried heroically to save the child, and had failed, it would have been recorded as an instance of infant mortality.
Roderick #60:
Please note that some primitve societies would leave their elderly out to die in the cold at night.
In our prosperous, modern society that practice is enacted not only by the proposed new health care regime but also by a massive scam called called “Cap and Trade” and is being done for the same reason: so that some can live more prosperously by not being bothered by worthless old people.
Larry Sheldon -
We paid, twice as it were. (Medicare + Federal Supplemental Group + what they would not cover)
Did you think I consigned her to the ice floe?
How do these (arbitrary?) definitions of viability effect national health statistics and comparisons between nations/systems? Is it possible to show that per capita spending tracks outcomes, and the U.S. has better outcomes than others proportional to spending? Where quality of life is measured as well as absolute life-span?
re: insurer/company deciding v. a government rationing. An individual can have a much larger impact on (their) company than they can have on their government. I don’t understand why people trust their government more than those institutions smaller and closer to them (who must in their own self interest value the individual more than the state).
“We paid, twice as it were. (Medicare + Federal Supplemental Group + what they would not cover)”
Therein lies the problem.
The belief that, having ordered and paid for an egg, you are entitled to all of breakfast and lunch if you chose it.
You enter a contract (or contracts, in this case). For the paid price, you are entitled to listed “benifits”.
No more, no less.
That is why as the good years rolled by we provide, on our own, the extras that might be required. (And given that the government has been meddling in and screwing up things since before I was born, we provided for ourselves in overlap so when the inevitable change or rules happened we wouldn’t be hurt too bad.
What we never saw coming was the deliberate destruction of value in our economy that we have seen the last year or so.
Means that we will have to move out of the house I had hoped to die in (recovering a little of that value we hope, but do not plan on.
Notice the focus here–your dependence on somebody taking care of you, our attempts to take care of our selves.
And don’t even start on how I must have been born with a silver spoon in my mouth–my parents did not have an electric dishwasher, six wide-screen TV sets, three cars, … (or their equivalents).
We lived for a bit in the garage behind a boarding house. Most of my childhood was lived in a house about the size of a car garage.
We are where we are by the grace of God, my parents hard work, my wife’s management, and my good fortune to have found and kept good jobs over the years.
Inspite of government’s best efforts.
The biggest evil of socialized health care is that the government decides who gets to live and who gets to die. This is what Obama wants for the US. This what he has been trying to do in the past. I do not know what it is against babies that Barry Soetero hates so much that he wants to kill them.