Dr. Ezekiel Emanuel, health advisor to Obama, has been talking about some pretty scary reforms. Claiming to be a bioethicist, he seeks to "redefine a physician's duty," medicine has to be thought of in a cost benefit relationship, and that the Hippocratic oath is an overshoot of morality which damages society "imperative to do everything for the patient regardless of cost or effect on others." In doing this we makes judgements about which patients should recieve extensive care treatments based on their age and social viability. He wants us to rank the importance of treating people of different age groups because of the money they will cost and the money they will make.
Every day, as physicians we make judgements about which patients are "hopeless," and which ones we feel in our hearts must walk out of the hospital and continue their lives. These feelings may be overly emotionally laden, but never would we dare it to be an economic feeling. Patients that are elderly and terminally ill that, as professionals, we know their illness is probably not amenable to extensive treatment, we educate them on end of life choices because of no other than a humanitarian obligation. We don't want to see them suffer. Of course we have to make judgements and we utilize resources prudently.
Patient autonomy must be the ruling factor. Never should we tell a patient that it is their time to die. When it is Dr. Emmanuel's time to pass on, will he accept someone else telling him that it is his time and we are not going to treat him? If one still feels the strength and wealth of life and want to go on despite all odds and expenditure, it is a basic human right that we allow them that.
If the technology is there and the patient desires an intervention, there is nothing to stop me or any morally driven person to withhold treatment.
