Like most living human beings, I bridle at the thought of a death panel deciding who lives and who dies. I’ve probably had more time to think about this that my readers have because I have had a long career in the dialysis business. Did you know that there once were panels that decided who was worthy of receiving life-saving kidney replacement treatments?
It wasn’t that long ago. In fact, it was happening right up until 1972. Dialysis machines were limited, each treatment was long and expensive and there simply wasn’t enough to go around for all who needed. Some of the criteria for being accepted were quite surprising.
- Age. No older people were accepted, meaning anyone over age 55.
- Marital status. Single? No dialysis for you.
- Value to society. Never mind no dialysis in jail programs which proliferate now, if you had a criminal record for anything you weren’t going to be granted access to continued life.
- No other medical conditions except kidney failure. No diabetics, no people with bone disease, no blind or deaf people. No nothing.
- Employment. You had to have a job. No wasting any high-demand treatment on those who were too sick to work and contribute to society.
Think about it. Would you qualify for dialysis in 1971?
Here’s an article from a 1987 medical/legal journal – ironically making an argument for rationing heart transplants – that has an interview with one of the panelists:
Chilling, is it not? The 1987 article still holds this record because the facts haven’t been white washed or disappeared from memory. You’d have a hard job finding any reference at all to it in contemporary journals. So that is a true and recent example of someone else deciding life maintaining treatment.
When it comes to self-determination of end of life situations, this is the truth:
“It’s not something that we like to talk about, but doctors die, too. What’s unusual about them is not how much treatment they get compared with most Americans, but how little. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care that they could want. But they tend to go serenely and gently. Doctors don’t want to die any more than anyone else does. But they usually have talked about the limits of modern medicine with their families. They want to make sure that, when the time comes, no heroic measures are taken.” Why Doctors Die Differently
link via Maggie’s Farm
I’m sorry they used the word “treatment” in that second sentence – it would be more accurate to say “end of life treatment” because that’s what we’re talking about here. There’s a big difference between making your own decisions about end of life plans and being denied treatment for non-terminal situations based on your age, your social habits or if you’re a U.S. congressperson.
Anyway, if you know any people who’ve been in healthcare for any length of time, you recognize the truth in this article. Go out and find a nurse anywhere in this country and ask them if they’ve ever joked about getting a tattoo that reads DO NOT RESUSCITATE across their chest. I bet they have. I’ve said it and I’m not joking.
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