Friday, August 28, 2009

Heck of a job

"Which patients should get a share of limited resources, and who decides? What does it mean to do the greatest good for the greatest number, and does that end justify all means? Where is the line between appropriate comfort care and mercy killing? How, if at all, should doctors and nurses be held accountable for their actions in the most desperate of circumstances, especially when their government fails them?"


These are the questions asked in the New York Times Magazine article about New Orleans' Memorial Hospital. You'll remember that, abandoned and without power with high winds and rising water making evacuation impossible, some patients, perhaps as many as 17 were given lethal doses of morphine and sedatives as an alternative to letting them suffer and die of heat, dehydration, starvation, drowning or from the failure of the machines keeping them alive. While the times appears to be asking questions about personal responsibility, the timing makes it vulnerable to being boarded and looted.

Rightly suspecting the imminent hijacking of this story by anti-health care propagandists, Hanna Rosin writes "pre-emptively" at Andrew Sullivan's The Daily Dish that
"this story shows the opposite of what would happen under government mandated health care reform. The reason the hospital staff got stuck having to make all these terrible decisions is because they were abandoned, and on their own. There were no established procedures, no regulations, no guidelines. There was just them, exhausted and overwhelmed, and a few dozen very ill patients unhooked from their respirators."
Would an HMO or a privately owned, for-profit facility have been better prepared or better able to get National Guard helicopters to the scene ipso facto? We can expect to hear that this is a logical conclusion. It's not.

I'm sure Rosin is right and that this, like any other pieces of flotsam that can be dragged out of the flood and into the argument will be used to show that the Government is poison and corporations are the antidote. In fact, that the government was unable to help in this circumstance owes much to the lack of planning and disdain for taking responsibility that has followed upon decades of Reagan-inspired sabotage of our institutions. Since there never really has been real evidence for the Reagan theorem that Government is the problem because it is the government and Government has no solutions and Government should give way to private, for profit management, the Republican controlled administrations have been forced to manufacture a scenario by insuring impotence, corruption and incompetence in almost all areas, including most obviously FEMA.

The Dish quotes an unidentified staff member as saying:
"This was totally against every fiber in my body.” But “we were abandoned by the government, we were abandoned by Tenet, and clearly nobody was going to take care of these people in their dying moments.”
and I'm sure this will be picked up on as though the failure is intrinsic to government itself and not to a government that was Rightie-rigged and Brownie led against adequate response.

Regardless of whether the euthanized patients could have been evacuated or should have been left "in God's hands" none of this makes a valid argument against public health care, but we're not used to validity or even honesty in this fight and this struggle to make us believe that the government of the people, by the people should be sold off and all decisions about individual life, liberty and pursuit of happiness be determined by how much profit it makes for someone else.

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