Sunday, August 23, 2009

Doctors Zira, Zaius and Zeke...with two of 'em, things'll be bleak!

White House Chief-of-Staff Rahm Emanuel's younger brother Ezekiel 'Zeke' Emanuel, MD, PhD, is a National Institute of Health Bioethicist. More importantly, Dr. Zeke Emanuel also acts as the White House Special Adviser on Health Care to President Obama, assisting him (and the Office of Management and Budget) on how to spend billions of our federal budget dollars on health care.

Dr. Zeke was one of the authors of a 2009 article advocating an 'allocation system' coined "The Complete Lives System".
Quoting Dr. Zeke from his article:

"Allocation of scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness...
We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles...
Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years. Treating 65-year-olds differently because they have already had more life-years is not ageist...
When implemented, the complete lives system 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 above sounds like no 'bioethicist' or doctor I've ever known, nor does it sound like it came from someone who believes in or practices the Hippocratic Oath. But then again, Dr. Zeke's career path started in the isolated world of Academic Medicine before he moved on to the Public Sector and now, of course, into The White House. There, Dr. Zeke can affect his kind of policy change because now, he has the President's ear.

It is in this spirit that I say to the 'bad doctor':
"Take your stinking paws off me you damn dirty bioethicist!"