“[W]e know that if this white-coated authority whose chosen vocation is curing and healing is the one opening your mind to hospice and palliative care, we’ve nudged you ever so slightly toward letting go.”1–Charles Krauthammer
“But it could be manslaughter, not murder. It’s not necessarily murder. But it doesn’t bother me what you call it. I know what it is. This could never be a crime in any society which deems itself enlightened.”2–Jack Kevorkian
“All they that hate me love death.”–Proverbs 8:36
Sarah Palin struck a nerve this summer when she said, on her Facebook page:
“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care. Such a system is downright evil.”3
Does the House of Representatives “health care reform bill,” HR 3200, really propose government “death panels” that would decide who should live and who should die?
The bill’s backers heatedly deny the charge; critics just as heatedly affirm it. Meanwhile, in August, the Senate Finance Committee removed all “end-of-life provisions” from the Senate’s version of the bill, “to avoid unintended consequences.”4
Before we report on the criticisms, let us be clear about the subject under discussion—HR 3200, 1,017 pages long in the online version certified by the Superintendent of Documents, U.S. Government Printing Office. All quotations from the bill are from this source.5
Specifically, we are looking at Subtitle C, Section 1233, “Advance Care Planning Consultation,” pages 424–430.
“[‘A]dvance care planning consultation’ means a consultation between the individual and a practitioner … regarding advance care planning, if … the individual involved has not had such a consultation within the last five years.” (p. 425)
The consultation is to include “advance directives, including living wills and durable power of attorney, and their uses” (p. 425).
–Also, “An explanation by the practitioner of the continuum of end-of-life services … including palliative care and hospice…” (p. 425).
–And, “the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order [for end-of-life counseling] should be updated periodically as the health of the individual changes” (p. 426).
Involved in a patient’s end-of-life care decisions, says the bill, shall be “representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state surveyors, agency responsible for senior services, state department of health, state hospital association, state bar association, and state hospice association” (pp. 427–428). We have emphasized those bodies that are agencies of the government.
Orders for treatment—or for limitation, or termination, of treatment—are to be signed “by a physician … or another health care professional (as specified by the Secretary …” (p. 429, emphasis added). “The Secretary” denotes the secretary of the Department of Health and Human Services, currently the ethically-challenged Kathleen Sibelius.
There is, of course, much more. The reader is encouraged to consult the text and see for himself.
There is no specific mention made of “death panels.” What we do have is:
–Mandatory end-of-life counseling (“advance care planning consultation”), at least once every five years, for everyone over a certain age or in a certain state of health: to wit, the elderly and the infirm.
–Patient-practitioner discussions are to cover the whole “continuum of end-of-life services,” but we are not told whether that “continuum” includes assisted suicide or any form of euthanasia. Certainly these are not specifically excluded.
–Government officials and bureaucrats, on up to the Secretary of Health and Human Services, are to be in on decisions involving patient care or termination of care.
“It’s surely not a death panel,” wrote Charles Krauthammer. “But it is subtle pressure applied by society through your doctor. And when you include it in a healthcare reform whose major object is to bend the cost curve downward, you have to be a fool or a knave to deny that it’s intended to gently point you in a certain direction, toward the corner of the sick room where stands a ghostly figure, scythe in hand, offering release.”6
Is the Stage Already Set?
Other critics speak more forcefully.
Dr. Richard Land, president of the Ethics and Religious Liberty Commission of the Southern Baptist Conference, told Chalcedon, “The persons serving on those end-of-life consulting panels will be trained by the government—professionally trained to manipulate people into agreeing to die.” But the whole bill, he said, is “horrible.”
“Unlike some of the Congressmen, I’ve read it,” Dr. Land said. “From Page One to Page 1,000, it is filled with a utilitarian philosophy. It’s all about the government intruding between patient and doctor.”
He added, “If Obamacare [HR 3200] becomes law, the vast majority of Americans will lead shorter lives filled with more pain and suffering.”
Jerri Ward, an Austin pro-life attorney, participated in a state-appointed “advance directive coalition” in 2006–2007. The panel was seeking consensus on how to reform Texas laws regulating end-of-life procedures—a consensus which was not achieved, she said.
“The state is already set for the kind of ‘end-of-life planning’ that we see in HR 3200,” she said. “Patients’ children and surrogates will be going to those counseling sessions, and we’ll wind up pressuring elderly people to remove feeding tubes, stop medication, etc.
“What I mainly see in my work with patients is hospitals running roughshod over families, manipulating families, playing family members off against each other, to terminate a patient’s treatment.”
Why? To save money, Ms. Ward said: and it will be done on a larger scale, she warned, if anything like HR 3200 becomes law.
Her experiences on the “advance directive” panel—serving with hospital administrators, doctors and nurses, social workers, a “medical ethicist” from Planned Parenthood—have not left her with a rosy view of health care reform.
“Every time I went into that meeting room, I felt like I was confronting evil,” she said. “I saw the face of evil in their utilitarian mind-set.”
The Push for Euthanasia
Dr. Gene Rudd, senior vice president of the Christian Medical and Dental Association, wrote recently on the CMDA’s website:
“To meet the cost pressures of this massive government-funded program, we can expect assisted suicide to be presented as a major economic solution. This process begins subtly under HR 3200 …”7
“Before Christ,” Dr. Rudd told Chalcedon, “hospitals did not exist. It was the followers of Christ who understood that Christ reached out and touched the leper, and invested Himself in the health needs of people all around him. Every life is sacred, and must be treated so. For us to create a health care system that didn’t do that would be immoral. The current proposals before Congress are not acceptable.”
Dr. Rudd found the language of Section 1233 especially troubling.
“Making the counseling sessions ‘mandatory’ is the first red flag,” he said. “It’s very wise for doctors to have this kind of counseling with patients, but it should not be mandatory.”
HR 3200 puts “far too much decision-making power in the hands of Health and Human Services,” he said.
Perhaps what makes the health care bill so alarming to so many people is that there is, indeed, a growing sense that our nation’s opinion-leaders are increasingly receptive to euthanasia as the solution to spiraling health care costs.
“The death of a teenager is a greater tragedy than the death of an 85-year-old,” wrote Peter Singer, in defense of health care rationing, for the New York Times Magazine this summer.8 Singer, a professor of ethics at Princeton University, is best known as the founder of the “animal liberation” movement. But he has long been an enthusiastic advocate of euthanasia.
Jack Kevorkian, the “Death Doctor,” received a very long prison sentence for helping his patients to commit suicide. However, it is beginning to look like the opinion-leaders of the Western world are catching up to him in their “enlightenment.”
In the United Kingdom, where “universal health care” has been in place for years, euthanasia’s advocates are more outspoken.
Baroness Warnock, supposedly Britain’s leading medical ethicist, raised hackles last year when she said, “If you’re demented, you’re wasting people’s lives—your family’s lives—and you’re wasting the resources of the National Health Services.”9 The 84-year-old baroness said certain patients have “a duty to die” and that she hoped people would be “licensed to put others down” if they are unable to look after themselves.10
It should not be imagined that Peter Singer and Lady Warnock are the only opinion-leaders saying such things.
Rationing Health Care
Critics of HR 3200 also claim the legislation would lead inevitably to the rationing of medical care, with the rationing decisions made by government bureaucrats.
“I lived in England, under socialized medicine, for three years,” Richard Land said, “and it’s horrible. I knew people in England who died, who wouldn’t have died in America, thanks to National Health. This bill [HR 3200] is modeled after the British system. It means late diagnosis, late treatment, and a higher death rate for Americans.”
The Telegraph reported a recent example of such rationing.11 “Tens of thousands with chronic back pain will be forced to live in agony after a decision to slash the number of painkilling injections covered on the NHS, doctors have warned,” wrote health correspondent Laura Donnelly.
Why take away these patients’ painkillers? Because doing so is expected the save the NHS 33 million pounds, cutting back from more than 60,000 treatments of steroid injections a year to just 3,000, the Telegraph reported.
The decision was made by the National Health Service’s “drug rationing watchdog” agency—the National Institute of Health and Clinical Excellence, acronymed NICE. The irony of this acronym will not be lost on C. S. Lewis fans. In his novel, That Hideous Strength, the villain is a satanic cabal disguised as a scientific body, the National Institute of Coordinated Experiments—NICE. We are amazed that an agency responsible for withholding medical treatment from suffering patients would claim to have anything to do with “clinical excellence.”
Can It Be Done Politically?
As if opening the door to medical rationing and euthanasia were not enough to damn HR 3200, the bill may also establish public funding for abortions and force doctors and nurses with religious objections to abortion to participate in abortions, Dr. Gene Rudd warned.
Even so, he said, some kind of legislation to improve health care in America might be acceptable.
“We do need to make some changes—but not sweeping changes,” he said, “in which we sweep away the whole foundation. So let’s make incremental changes, as needed. After all, the needy cannot go unattended.
“Government can be involved in health care. But if that government has a worldview that is against Scripture, then, no—it cannot be involved.
“Power corrupts. When you give power without accountability, or principles to guide those who exercise that power, there is great potential for corruption. If the government has a worldview in which power is an end in itself, then the government has to stay out of health care—absolutely.”
Richard Land said, “In a country as wealthy as ours, we ought to provide a basic standard of health care for every citizen.” But he hedged this statement with several caveats.
“Let’s face it,” he said, “a single-player, NHS-type health care system has been the Holy Grail for liberals for the last fifty years.
“Democrats, however, have fundamentally misread the 2008 election results as a mandate to turn us into a statist, neo-socialist society. And now the American people are revolting against this rampant statism, and the people in Washington are stunned and shocked. They can’t believe what they’re hearing at all those town hall meetings.”
Dr. Land said he has been in private conversations with many so-called Blue Dog Democrats in Congress.
“The leaders in Congress have threatened to push this thing through with Democratic votes alone,” he said, “but I don’t think they can. There are too many Blue Dogs who could never be re-elected in 2010 if they voted for this. But even if they did push it through, before something of this magnitude could be implemented, it could be stopped by the new Congress.”
But if anything like HR 3200 were to become law, he said, then “Many people who aborted their babies, years ago, will find themselves being pressured to die before their natural time.”
Ironic, isn’t it, that if the approximately fifty million babies aborted in America since Roe v. Wade had been allowed to live, millions of them now would be working and generating wealth in a country supposedly concerned with becoming unable to pay for Social Security, Medicare, Medicaid, and health care?
The Proper Role of the State
“Health care reform” is another example of what Richard Land called “liberals looking upon the state as a replacement for God.”
R. J. Rushdoony, in Thy Kingdom Come, wrote of what the state and the civil government ought to be, according to Scripture:
The state has a duty to serve God, to be Christian, to be a part of God’s kingdom, or else it shall be judged by Him. The state is declared in Romans 13 to be a ministry, the ministry of justice and social order … every area of life is strictly limited in its scope by the word of God. The state as civil government is strictly limited in that, first, it is under God and must administer justice in faithfulness to His word. Second, the state cannot assume as its own those areas which are properly the spheres of the home, school, church, art, economics, or anything else. Third, the state cannot limit the individual’s freedom to work out the divine mandate for man as God’s image-bearer. Fourth, the authority of the state is at all times ministerial, or delegated from God, not creative or independent. When the state becomes messianic in its claims and tries to usher in paradise, it has done so by declaring itself to be a god and by making itself the source of law and authority … It is man’s attempt to be God and create his own new world.12
In light of Rushdoony’s observations, the critics of HR 3200 do not go far enough in their criticism.
What has legislation like this to do with administering justice and preserving social order? By “justice” we mean no such inane hypocrisy as “social justice,” but plain, old, everyday justice—the state’s duty to protect its citizens from evildoers and punish convicted criminals. Taking care of the sick has always been the province of families, churches, and the medical profession.
“Health care reform” envisions a vast government takeover of a major sector of America’s economy. The state shall be assuming responsibilities that do not belong to it, Biblically or constitutionally. In doing so, it would be further limiting individual freedom, replacing it with bureaucratic mandates.
HR 3200 glaringly reflects the messianic pretensions of the welfare state. This is not authority delegated to the state by God: it is, as Rushdoony clearly saw, the state pretending to be a god.
By their fruits you shall know them. Government health care has been an abject failure in one country after another. Ask anyone in England who suffers from chronic back pain and now cannot get treatment for it.
Why, then, should anyone want to follow the example of those countries?
None of the critics we spoke to brought up the obvious objection that the federal government is already too big, too corrupt, too wasteful and inefficient, too powerful, and too intrusive; and that rather than being made bigger, costlier, more corrupt, more wasteful, more powerful, and more intrusive, our elected representatives should concentrate on chopping it down to a size more conformable to the Bible and the Constitution. We should be shrinking the government, not growing it.
Perhaps there are those in Congress fool enough to think that government health care will succeed in America, even though it has failed everywhere else. But there must be other promoters of this project who, knowing it will make our health care system worse and not better, nevertheless press on—because their real intent is to increase the power of the state. In their incessant promotion of euthanasia, assisted suicide, sodomy, and abortion, they show themselves, in the words of King Solomon, to “love death.” From their kind may the Lord deliver us.
6. Krauthammer, op. cit.
7. “News & Views,” Aug. 5, 2009, on http://www.cmda.org/
8. Peter Singer, “Why We Must Ration Health Care,” New York Times Magazine, July 15, 2009.
11. “Patients forced to live in agony after NHS refuses to pay for painkilling injections,” by Laura Donnelly, Health Correspondent: Telegraph.co.uk, Aug. 2, 2009.
12. R. J. Rushdoony, Thy Kingdom Come (Vallecito, CA: Ross House Books, (1970) 2001), 191.