December 25, 2008
1962 New York Times: launch of outpatient chronic dialysis raises questionsBy Bill Peckham
A New York Times archive search turned up this article from May 6, 1962 describing the dialysis selection process developed in Seattle to organize access to chronic hemodialysis. The article followed on a 10 minute talk Dr. Scribner had given at the American Society of Clinical Investigations meeting in Atlantic City weeks earlier.
The talk was a show stopper. This NYT article led later that year to the longest story ever published in Life magazine and a television documentary on NBC by Edwin Newman. It was an interesting moment in history - the birth of bioethics. From the start many ethical and moral questions were raised by this new technology.
The article ends by making the point that:
In some cases, this extra life granted by the accomplishments of science, can almost be normal. In others, it is, at best, invalidism for which there is no cure ... How may a physician make the choice and where must he draw the line between artificially prolonged life and natural death?
How much has really changed in half a century? Now this choice is being made by payers not doctors. Where should payers draw the line? Is it enough to create a system that prolongs a life of invalidism? Or must payers support care that can grant a life that is nearly normal? Scribner faced the dilemma forthrightly, 46 years later payers and providers are dodging this moral question with an egalitarian approach of suboptimal dialysis for all.
http://www.billpeckham.com/from_the_sharp_end_of_the/2008/12/1962-new-york-times-launch-of-outpatient-chronic-dialysis-raises-questions.html
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