Death panels on steroids

If you want to see what direction health care is going, just read the July 12 issue of The New England Journal of Medicine (NEJM).

Of course, reading a medical journal isn’t on most people’s “to do” lists. Even medical professionals who do read journal articles rarely do so to gain insight into the latest shifts in the cultural or political winds.

That’s a mistake. These days, radical trial balloons are often launched from such “venerable” publications — which is especially disturbing because the imprimatur of the medical intelligentsia provides respectability to ideas that otherwise would be dismissed out of hand. The mere fact that an idea appears in what The New York Times describes as “perhaps the most influential medical publication in the world,” places that concept firmly within the realm of respectable debate.

Which brings us back to the NEJM.

On its pages, the NEJM has long featured articles favoring euthanasia and assisted suicide as well as health care rationing. Indeed, two of its former editors, Dr. Arnold Relman and Dr. Marcia Angell, are vocal advocates of eliminating the private health system and replacing it with a single-payer, government-controlled health system. And both are among the 14 subscribing petitioners on a doctor-prescribed suicide initiative that will appear on the November 2012 ballot in Massachusetts.

Angell is so enamored with the concept of assisted suicide that, in a 2004 article, she decried the fact that too few people were availing themselves of Oregon’s doctor-prescribed suicide law. She expressed concern that the law was too restrictive.

Now, the NEJM has given a platform for Dr. Lisa Lehmann, director of the Center for Bioethics at Brigham and Women’s Hospital in Boston, and researcher Julian Prokopetz to lay out a proposal for facilitating what they call “assisted dying.” In their article, “Redefining Physicians’ Role in Assisted Dying,” the authors address what they see as a real problem: There aren’t enough doctors willing to participate in assisted suicide.

As the authors state, “Many medical professionals are uncomfortable with the idea of physicians playing an active role in ending patient’s lives.” Furthermore, they explain that the American Medical Association and various state medical groups oppose legalization.

It should be noted that when Washington and Oregon changed their laws to permit assisted suicide, they did not make all assisted suicide legal. For example, one’s mechanic, plumber, attorney, professor, or spouse is not given the authority to assist suicide. Essentially, what was made legal in those states — and what is funded by state and private insurance — is one type of assisted suicide: doctor-prescribed suicide.

It is the necessity of a doctor who will prescribe the deadly dose which presents a stumbling block that Lehmann and Prokopetz seek to address. As they explain, “We believe there is a compelling case for legalizing assisted dying, but assisted dying need not be physician-assisted.”