Tuesday, January 03, 2006

My Body is My Business, Even When Unconscious

I like would to preface this message my saying that I have been reading to the Slate.com and listening to its podcasts off and on for a year. I have begun to realize that while many of its writers are willing to see issues completely, others, like Steven E. Landsburg, seem set on lashing out against those who cannot accept the world as they - and in this case, the conservative status quo - see it. Unfortunately, very biased writers are not vetted more thoroughly by Slate's editorial staff.

Recently, Tirhas Habtegiris, who, like many working class Americans, did not have health insurance, unfortunately ended up in Baylor Regional Medical Center at Plano with advanced lung cancer. Not only was she unable to provide for her own health care, but her family was not the position to pay for what must have been costly care for the not only lung cancer but other palliative care. Despite these terrible circumstances, Baylor Regional decided to unilaterally decided to remove this woman from life support, instead of trying to work with family to their financial situation.

Mr. Landsburg's article seems to belittles any blogger who considers the hosptial to have an obligation to try insure this woman receives complete and quality medical care before deciding to discard her to turn over hospital like a sort of medical McDonalds:

Here, for the edification of bloggers everywhere, is an example of an economic consideration: If you ask people—and especially poor people—what their most dire needs are, you'll find that "guaranteed ventilator support" ranks pretty low on the list. OK, I haven't actually done a survey, but I'm going out on a limb here and predicting that something like, say, milk, is going to rank a lot higher up the priority list than ventilator insurance (Landsberg, paragraph 3).
While agree that most low income American would probably choose a necessary like milk over Landsburg's chimera of "ventilator insurance," hospitals, and society in general, have are a responsiblity to care for the weakest among us. We should not just make decision for other about how they died because we have failed at trying to balance free market health care system with resonable care for working poor and indigent, and their living constitutes a burden on the medical system.

Lansberg continues to do the issue a diservice by taking away from the issue, making this crisis not about the pathetic state of health care industry in this country but about the opportunity costs of "ventialor insurance" :

Now let me remind you what "compassion" means. According to Merriam-Webster Online (which, by virtue of being online, really ought to be easily accessible to bloggers), compassion is the "sympathetic consciousness of others' distress together with a desire to alleviate it." By that definition, there is nothing particularly compassionate about giving ventilator insurance to a person who really feels a more urgent need for milk or eggs. One might even say that choosing to ignore the major sources of others' distress is precisely the opposite of sympathetic consciousness.


At that point, there's a powerful human instinct to come to the rescue. Well, more precisely, there's a powerful human instinct to demand that someone else come to the rescue. (I'm guessing that in the wake of the Habtegiris case, nobody at the Daily Kos has taken to funding ventilator insurance for the poor.) (Landsberg, paragraphs 5 and 12)

This argument has nothing to do with insuring American poor for guarantee ventilator access but the state of health care in America and our society lack of commitment to the poor. If we could have a system which maximizes the benefits of free market health care system with a government security for those who are of low income, we will not only face the dilemma of whether or not to end life of simply the hospital's economic situation. I believe that if there a decision between "ventilators versus tax cuts or ventilators versus foreign wars," then the health of American citizen should win whenever possible. No man can enjoy a tax cut from the grave and may curse it in his sick bed. Being a Judeo-Christian society (which many on the religious right seems to try to remind us of continually), we have an obligation to take care of less among us. This moral mandate includes making sure that we choose to maintain life when a patient's personal wishes are uncertain.

While Steven Landsberg wallows in the pregnant chads of Tirhas Habtegiris story, we must remember the big picture: each person should be allowed to have equal access to preventive and urgent, living-saving health care

For More Information

The Daily Kos

- YucatanMan goes into greater detail both other aspects of this issues, including race and the current Bush involvement in the Texas law which allows for such a situation to occur.

Do the Poor Deserve Life Support?

- Steven Landsberg's Article