Via R.S. McCain.
Teddy Kennedy freely embellished the term 'Star Wars' on President Reagan's vision of the Strategic Defense Initiative and the fat ass from Mass was never called on it. But when Sarah Palin uses 'Death Panel' to describe Zeke Emanuel's view on how to limit government run health care for the elderly, the press calls her crazy. What would have been a better term to describe the Dr. Death Of The New Century's paper on how to ration government health care(PDF file)?
This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. 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. Conversely, 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. A less obvious example is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason. [emphasis and bold mine]
Clearly, more needs to be done to elucidate what specific health care services are basic; however, 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 care services. Perhaps using this progress in political philosophy we can begin to address Dan's challenge, begin to discuss the goods and goals of medicine.
End Of Life Mercy Specialists? Yeah, that's better.