bye bye Pro life Ethicists

Years ago, I cornered a famous medical author at one of his speeches, and we discussed the teaching of medical ethics. I thought it was pretty bad (maybe because my readings were limited to the "apologists for death" who were on the forefront of the new medical ethics.


I thought I had a novel idea on how to instruct medical students in how to learn medical ethics: Why not use great literature?

For example, Tolstoy's story the Death of Ivan Ilych in mind: Where the dying man goes through denial and pain, while his family starts avoiding him.

It's a painful story, but in it we see a lot of the problems our patients face in death and dying.

The author looked at me strangely, and said: well, yes, but that's what the (then recently elected) Bush Bioethics panel had done.

And indeed, looked up the website I found that they had published such a book, and had excerpts on the web, that uses excerpts from great literature to begin discussions to teach ethics in medical schools or classes.

I should have guessed things had improved, since Bush had appointed Leon Kass to head the Ethics office.

I had read Kass' books, which were subtle and profound; they always made me think about consequences that are easily overlooked in our soundbite world.

And if you go to the website you will find a lot of books there, that not only discuss the dilemmas of medical ethics, they do so from various points of view and include discussions of subtle "side effects" on society that would result from embracing technological changes.

Such subtleties are often dismissed by more pragmatic, who pooh pooh such cautionary observations as exaggerated.

Later, Kass was replaced with Professor Pelligrino.

Pelligrino had long been marginalized by the bioethics community because he was pro life: He even defended the Hippocratic oath (how gauche).,

The opposition however to the bioethics panel was loud and constant, and it didn't help that some people who should know better took Kass' and others opinions out of context to call them right wing.

In actuality, the Bush panel had a wide range of ethicists, from all sides of the spectrum; but of course in this day and age unless one is 90% pro death it won't pass the test of the NYTimes.

But worry no more.

Two weeks ago, President Obama fired the entire Bioethics panel even though the panel was due to be changed next fall.

Apparently, those pushing the health agenda of the president couldn't wait, perhaps because they are busy pushing a health care bill that will probably be passed unread by Congress in the near future, as other recent bills on global warming and economic recovery were passed unread.

The the reason given for the sudden and premature firing of the entire panel was that the president didn't want a group to philosophically discuss all those nuances: he wanted a group that would develop a "shared conscensus", according to Reid Cherlin, a White House press officer.

President Obama will appoint a new bioethics commission, one with a new mandate and that “offers practical policy options,” Mr. Cherlin said.

But of course one suspects what this means is that the Obama administration wants a Bioethics panel to give him ethical cover for his health care policies, not one that will discuss the pros and cons and maybe show the overlooked pitfalls of things like medical rationing, legalized abortion paid for by all taxpayers, or not treating the elderly and the handicapped if some bureaucrat decides their quality of life is too low.

One only has to look to the British Health care system, where the bureaucrats of the N.I.C.E.(National Institute of Clinical Excellence) make the guidelines on what treatment is allowed and what treatment is inadvisable according to their "quality of life" calculation.

Similarly when Hillary Clinton was pushing the Clinton health care plan in the 1990's, she told Congress that the plan wouldn't withhold any medical treatment from a patient "unless it would not improve their quality of life".

In other words, one can easily imagine the US version of NICE telling doctors who wished to treat an older person, a handicapped or a retarded citizen, that the treatment would not "improve their quality of life" at all: It would merely allow them to live their own life, which (by the standards of many so called ethical criteria) was inferior.

And Nat Hentoff remarked: Improve their quality of life? Where is it in the constitution that says the government has the right to decide who won't get treated because of their quality of life?

When the now defunct Clinton Health Care plan was being pushed, one red flag to it's eventual agenda was that most of the ethicists advising the plan were pro euthanasia and pro rationing.

So one now waits to see how "fair and balanced" the Obama Bioethics panel will be.