You would think that an ultra liberal newspaper like the New York Times–which claims to believe in human equality–would look askance at an advocate who argues that parents should be allowed to murder their babies if the child does not suit the interests of the family. Illustrating how off the rails contemporary liberalism has become, the Times loves Peter Singer.
But to the point: In this installment of his ongoing campaign to dismantle human exceptionalism and instill utilitarianism as the foundational value of society, Singer pushes health care rationing. In the process, he shows how the “quality of life ethic” that he endorses would discriminate against the ill, the elderly, and people with disabilities. From “Why We Must Ration Health Care:”
Some will object that this discriminates against people with disabilities. If we return to the hypothetical assumption that a year with quadriplegia is valued at only half as much as a year without it, then a treatment that extends the lives of people without disabilities will be seen as providing twice the value of one that extends, for a similar period, the lives of quadriplegics. That clashes with the idea that all human lives are of equal value. The problem, however, does not lie with the concept of the quality-adjusted life-year, but with the judgment that, if faced with 10 years as a quadriplegic, one would prefer a shorter lifespan without a disability. Disability advocates might argue that such judgments, made by people without disabilities, merely reflect the ignorance and prejudice of people without disabilities when they think about people with disabilities. We should, they will very reasonably say, ask quadriplegics themselves to evaluate life with quadriplegia. If we do that, and we find that quadriplegics would not give up even one year of life as a quadriplegic in order to have their disability cured, then the QALY method does not justify giving preference to procedures that extend the lives of people without disabilities over procedures that extend the lives of people with disabilities.
This method of preserving our belief that everyone has an equal right to life is, however, a double-edged sword. If life with quadriplegia is as good as life without it, there is no health benefit to be gained by curing it. [Me: Sophistry alert!] That implication, no doubt, would have been vigorously rejected by someone like Christopher Reeve, who, after being paralyzed in an accident, campaigned for more research into ways of overcoming spinal-cord injuries. Disability advocates, it seems, are forced to choose between insisting that extending their lives is just as important as extending the lives of people without disabilities, and seeking public support for research into a cure for their condition.
But the two concepts aren’t at all inconsistent and hence, no such choice is necessary. Singer is merely conflating whether one would prefer to not be disabled with the intrinsic equal value of the lives of people with disabilities, as if both positions cannot be held at the same time. Using Reeve, there is no question he wanted to walk again. But that doesn’t mean that his life had less value because he couldn’t.
And here’s a scary thought: Rationing would put bioethicists of the ilk of Peter Singer in charge of who received or did not receive wanted care. If that doesn’t turn you off the rationing agenda, what will?
July 15th, 2009 | 9:49 pm
I have an idea-we should use quality adjusted life years to determine the healthcare options of ableist bigots. They are obviously terminal with no hope of a meaningful recovery.
July 15th, 2009 | 10:00 pm
[...] HT: Wesley J. Smith at Secondhand Smoke. [...]
July 16th, 2009 | 11:38 am
[...] country has ever seen. First, it is now clear that President Obama wants utilitarian bioethicists of the ilk of Peter Singer to decide what treatment you can have and what you can’t have. From the story: In an [...]
July 17th, 2009 | 8:18 am
Singer made three major errors about Sutent
One: The median survival is over 2 years, not a few months…since that includes non responderes,, that means an even hgher life span for those who respond to the medicine…and there are other medicines waiting in the wings…
Two: the price will undoubtably go down as it is used more.
and the big one:
Three: NICE now funds Sutent for clear cell renal carcinoma.
Wonder who fact checked the article?
July 17th, 2009 | 12:00 pm
I agree with the Nancy Reyes’ comment that the article is full of false tradeoffs. But, healthcare is in reality rationed by a number of forces – market forces, lack of perfect distribution of available technologies and skilled providers, and intangibles. This is why I fear putting the federal government at the center of these realities. The government will become the sole player in determining all of these tradeoffs and can really “play God” according to ideologies, financial considerations, and other superficial determinants that will be called “policy.” The government will be the sole rationer, while a more diffuse set of rationers would be better, including families and moral considerations guided by their accepted clergy. My elderly father-in-law died last year in Europe, and he had been disabled for years from a variety of causes. Yet, my petite, indefatigable mother-in-law kept him going through a combination of nurses, home health aides (including immigrants of questionable documentation) and consistent application of his mainstream drugs. They spent all of their money on this. In fact, she died suddenly before him, and within four months, he died without her attentive care. Though he could not normally speak, as she lay dying in another room, he began to speak to her fluently in his native language. Why did he ultimately die? He was by that point in a professional care facility. Did he miss her, or was the care less optimal? So many levels of decision were involved, but all of them taken by family in his best interests, up to the limit of what could be done. Yes, there were bureaucracies involved, and there were limitations on funding, staffing, and technologies. But all were at peace. I once served on a medical malpractice trial jury in a similarly diffuse situation where an elderly lady with more than one degenerative diseases died in a hospital, wherein the family alleged that all of these factors converged on the doctor. The plaintiff family was clearly not at peace. Imagine the social factors that will be generated if the government is the sole rationer, guided by considerations that are not accepted by everyone.
July 17th, 2009 | 1:46 pm
Rationing in the context of health care means the gov’t makes decisions on who gets what treatment. Singer’s Sutent example is not rationing. A private insurance company would not likely put a $10 million (or whatever number they choose) drug on their formulary. The patient can then choose to puchase the drug or not. You can say the market rations, but that’s wholly different from the government rationing.
July 18th, 2009 | 6:24 pm
I continue to be enraged at Princeton for employing someone who constantly engages in anti-disability hate speech. It’s disgusting. It’s like asking a neo Nazi to come work in a college philosophy department and then excusing his or her disgusting rhetoric because “it’s just ideas.” Bullpucky. Peter Singer’s philosophy focuses on Practical Ethics. That means applied ethics. He isn’t just throwing ideas out into the sea of academia. He wants his ideas to become policy, of which he will not be a victim because he is able bodied. It makes me want to shake him.
July 19th, 2009 | 9:11 pm
Did he seriously just make the argument that if life with a disability is preferable to an early death, then disability is not worth curing? I don’t know about Singer, but I would rather be healthy than disabled, and I’d rather be disabled than dead. Seems pretty straight-forward to me.
August 2nd, 2009 | 7:07 am
I’m a former National Merit Scholarship finalist, practiced law creditably and without a disciplinary or corrective action for 35 years, etc. Oh, I forgot to mention, I was born with traumatic occipital lobe damage and an agenesis of the corpus collossum which conencts, or is supposed to connect, the right and left hemispheres of the brain, have no depth perception and never could see well enough to drive or hit or catch a baseball, etc., and, after, and, as I have been told by an eminently knowledgeable and credible witness, because, I discovered that a client [actually more than one] had been incestuously molested by her prominent and politically and officially powerful father, and had, as an interrogation technique, offered, very privately, to bet her mother that this had happened before first grade [she didn't offer to bet against me, respond, or bat an eye because she knew], I have been committed to a state mental hospital for three months, and suspended from practice the practice of law indefinitely for mental disability in my absence, and forced onto SSI disability payments and other forms of “welfare” although the allegations against me were related solely to such life-long physical disabilities and a palpably incredible allegation that I was at imminent risk of suicide. Nobody had suggested that I should be committed or suspended when I had told the State Bar about getting help after a very recent actual suicide attempt, or had later spoken publicly on television about this history, suicide prevention, treatment. I have affidavits from the only psychiatrist who had actually known or evaluated me before reaching his or her decision, from the judge at whose court I was taken into custody on the first of two back-to-back mental health warrants, and others, but the State Bar won’t consider them or even admit having notified me, or provide me with a copy, of their original charges against me, my copy of which was stolen. I’m also over retirement age now.
I had been at a State Bar sponsored Continuing Legal Education program on mental health law, which I had practiced actively, when a prominent local attorney, son of a former judge, had announced that he did not believe in suicide prevention and instead believed in euthanasia, and “forced euthanasia” of all “mental patients.” Some of us just looked at each other in shock and disbelief. In hindsight, I wish I had given vent to my first reaction with a rousing Nazi “Seig! Heil!,” but those of us who knew each other’s histories of treatment for depression, etc., just looked at each other and shuddered.
Any bill that Professor Singer, not to mention some Obama Administration appointees like former Democratic Senate leader, McCain house guest, and Obama’s first choice for Health & Human Services secretary Tom Daschle, Holdren, Ezekiel Emanuel, his Chief of Staff’s brother, all of whom have publicly endorsed this anti-life agenda, support, I have to oppose.
Links
Blogs
Find Us
Contact