Wednesday, August 12, 2009

"Doctor Death" Dislikes Being Quoted

Via Memeorandum:

Dr. Ezekiel Emanuel, brother of Rahm Emanuel and currently acting as Special Advisor for Health Policy, is upset that is own extensive writings as a medical ethicist are being cast in a negative light. Emanuel is claiming that his writings are being intentionally misconstrued. You judge:

Ezekiel Emanuel wrote an article for The Hastings Center Report in 1996, in which he suggested that public deliberative forums should decide which health services should be socially guaranteed, and that those services "that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations" might be considered by this deliberative body as "basic", while "services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed".

Then there is this:

May 31, 2008 (LPAC)—Ezekiel Emanuel, MD, called for a reinterpretation of the physician's Hippocratic Oath to take account of "costs" and "effect on others" (like HMOs), in an article in JAMA of June 18, 2008. The brother of Obama's chief of staff, Ezekiel Emanuel is a top designer of Obama's Hitlerian medical-care "reform," as health-care advisor to Peter Orszag's OMB and a member of the Federal Council on Comparative Effectiveness research. He wrote:

"At least 7 factors drive overuse [of medical care], 4 related to physicians and 3 related to patients. First, there is the matter of physician culture. Medical school education and postgraduate training emphasize thoroughness. When evaluating a patient, students, interns, and residents are trained to identify and praised for and graded on enumerating all possible diagnoses and tests that would confirm or exclude them. The thought is that the more thorough the evaluation, the more intelligent the student or house officer. Trainees who ignore the improbable 'zebra' diagnoses are not deemed insightful. In medical training, meticulousness, not effectiveness, is rewarded.

"This mentality carries over into practice. Peer recognition goes to the most thorough and aggressive physicians. The prudent physician is not deemed particularly competent, but rather inadequate. This culture is further reinforced by A UNIQUE UNDERSTANDING OF PROFESSIONAL OBLIGATIONS, SPECIFICALLY, THE HIPPOCRATIC OATH'S ADMONITION TO 'USE MY POWER TO HELP THE SICK TO THE BEST OF MY ABILITY AND JUDGMENT' AS AN IMPERATIVE TO DO EVERYTHING FOR THE PATIENT REGARDLESS OF COST OR EFFECT ON OTHERS."

And there is the now infamous"Principles for allocation of scarce medical interventions" in the journal The Lancet which attempts to assign "value" to patients based on their life stage.

As repugnant as I find Dr. Peter Singer, I give him credit for standing by his body of work. Emanuel feigning "hurt feelings" that his work is misunderstood smacks of incredulous, self-serving political theater. Like Singer, he said it, he should stand by it.

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