NEW YORK, Sept. 5 /PRNewswire-USNewswire/ -- Reporter Jim Rutenberg of the New York Times published a profile of me. (September 5, 2009) Mr. Rutenberg accused me of making false statements, but gave no evidence. Below you will see the evidence proving my statements are true. Mr. Rutenberg is the one writing falsehoods. When Mr. Rutenberg requested a personal interview, I declined because personality profiles are not what's needed. The focus should be on the health bills, not on personalities.
After a careful reading of H.R. 3200 and the Kennedy bill, I have explained the dangers of these bills in numerous articles. For the most part, these substantive issues are not discussed in Mr. Rutenberg's profile. He did make two claims that need to be addressed: He claimed, without providing evidence, that I "incorrectly" depicted the end of life consultation program in H.R. 3200 and he claimed that I falsely described Dr. Ezekiel Emanuel's views in a 1996 Hastings Center publication. Because these claims are important to the medical care of the American people and to my own credibility, they must be addressed.
Mr. Rutenberg sent me a list of written questions before writing his profile, and I responded in writing. Here are the e-mailed answers I sent him verbatim. He did not include this evidence in his profile or rebut it.
ON END OF LIFE COUNSELING:
Partisans for the legislation claim it simply provides Medicare coverage for end of life counseling sessions. That would have taken one or two lines in the bill, not six pages.
The bill lists what "shall" must be covered in the consultations, a decision that should be left to the patient and doctor, not prescribed by government. (425-430) The bill's partisans say the consultation sessions are voluntary. But if there is a penalty for noncompliance, then it is not voluntary, regardless of whether the word mandatory used. The penalty is on page 432. Doctors' quality ratings will be determined in part by the percentage of the doctor's patients who create a living will and the percentage who adhere to it. (And quality ratings affect a doctor's Medicare reimbursement)
The "adhere to" part is especially dangerous. Some people say "they'd rather die than be on a ventilator, but when the time comes, they choose to live. Doctors will incur penalties when families do not adhere to end of life written plans. - a horrible conflict of interest. As a patient advocate, I see these difficult situations and know that government should not be involved. Paying for consultations, that's fine. But the bill goes much farther.
ON MY DESCRIPTION OF EMANUEL'S 1996 ARTICLE:
Here is the Emanuel quote verbatim as printed in the Wall Street Journal, August 26, 2009): "Substantively it suggests services that promote the continuation of the polity -- those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations -- are to be socially guaranteed as basic. Covering services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic, and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia."
This quote from Emanuel's article in the Hastings Center Review was not taken out of context. It was quoted at length to ensure fairness and accuracy. Let's make the passage even longer: The sentence immediately before the quoted passage makes his intention clear: "The civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health resources."
Then the "substantive insight" is quoted in my article, (Wall Street Journal, August 26, 2009) along with the "obvious example" of "not guaranteeing health services to patients with dementia." And then he reemphasizes the positive contribution "communitarianism" offers: "the overlap between liberalism and communitarianism points to a way of introducing the good back into medical ethics and devising a principled way of distinguishing basic from discretionary health services."
Going beyond this article, Emanuel's subsequent writings are consistent with expecting doctors to compromise the needs of an individual patient in order to advance the common good. His discussion of the Hippocratic Oath, quoted at length in my piece, puts forward the same viewpoint. He advocates retraining physicians to provide "socially sustainable care." My description of his work is accurate, fair, and nuanced. Please check with the people you've quoted in his defense to see if they've read his articles. Have you read them?
You should be aware that Dr. Emanuel is part of a school of thought that imposes on doctors the duty to serve society and advance "population health" rather than focusing on the needs of their own patient. I have long opposed this view, and it would be rash and unfair to ascribe my views to partisanship.
If only more reporting on the health care issues focused on the content of the bills, rather than superficial attacks. I will be addressing both the issues raised here: the dangerous ideas of Dr. Emanuel and the purpose of the end of life program provisions in HR 3200 -- at a rally on the lawn of the U.S. Capitol on September 12th. See you there!!
Betsy McCaughey, Ph.D., is founder and Chairman of the Committee to Reduce Infection Deaths and former Lt. Governor of New York State.
|SOURCE Committee to Reduce Infection Deaths|
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