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The San Francisco Chronicle carries a helpful op/ed piece by two physicians to day on the mandatory counseling requirement in the Obamacare House bill by physician and USC School of Medicine professor emeritus Katherine Dowling Schlaerth. From her column:

This current legislation...seeks to prevent...costly overuse of health resources through a program of “advance care planning consultation,” wherein those on Medicare, or their families, could meet with a “practitioner of advance care planning” every five years, or sooner if illness supervened. Such an adviser need not be a physician, either. [Me: This is where the assisted suicide advocacy group Compassion and Choices would come in, as it is seeking to reposition itself as an educator of end of life choices]

This specialist would discuss care issues such as “the individual’s desire regarding transfer to a hospital ... the use of antibiotics and the use of artificially administered nutrition and hydration.” The discussion may, in fact, be triggered if “there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease.” I would be loath to talk a person on dialysis or in a wheelchair from a stroke into forgoing antibiotics for a pneumonia that may itself be treatable.

HR3200 has created tiers of administrators, who do not necessarily have medical experience. They will attempt to facilitate your end-of-life care, probably with the assistance of the electronic medical records each medical facility will shortly be required to use.

These and other provisions of the health choices act frankly scare me. As a physician, I took an oath long ago to put my patient’s interests above all else, but provisions in the bill have a quality of coerciveness that make me wonder if I can fulfill my oath.

She’s right. When taken overall, this bill seeks to destroy the Hippocratic value that each physician give optimal care to each patient as an individual, and replace it with a divided loyalty in which there is also a duty to the public or to society.  History shows that once such a dual mandate is instituted, the weak and vulnerable are the ones to suffer. Be afraid. Be very afraid.

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