Health Care 'Death Panels' Aren't New. They Exist Now

Health Care 'Death Panels' Aren't New. They Exist Now

1:06 am

August 24, 2009

By Frank James

The canard that the health-care overhaul proposals include provisions for death panels prompted an interesting Washington Post piece by John Buntin, a writer for Governing magazine who observed that there really were death panels once upon a time and that the federal government stepped in to put an end to them.

The death panels Buntin writes of emerged after the development of dialysis in the post-World War II period.

The committees were created because of the relative scarcity and expense of dialysis treatment in the first few decades after the invention of the procedure.

An excerpt from Buntin's piece:

In 1962, with help from a $100,000 foundation grant, Seattle's King County Medical Society opened an artificial kidney clinic at Swedish Hospital and established two committees that, together, would decide who received treatment. The first was a panel of kidney specialists that examined potential patients. Anyone older than 45 was excluded; so were teenagers and children; people with hypertension, vascular complications or diabetes; and those who were judged to be emotionally unprepared for the demanding regimen. Patients who passed this first vetting moved on to another panel, which decided their fate. It soon gained a nickname -- the "God committee."

Born of an effort to be fair, the anonymous committee included a pastor, a lawyer, a union leader, a homemaker, two doctors and a businessman and based its selection on applicants' "social worth." Of the first 17 patients it saw, 10 were selected for dialysis. The remaining seven died.

According to Buntin, the government's concern about these committee's offending the public's sense of fairness led Congress in 1972 to expand the Medicare program to include dialysis.

Buntin's point about the federal government actually taking steps to end the practice of God committees, at least for dialysis treatment, is well taken.

And his piece reminded me of that God committee's aren't consigned to history. They still exist but now, instead of determining who gets dialysis they decide who gets a transplanted organ. This web site for the Methodist Hospital system in Texas explains the role of the kidney transplant committee there.

An excerpt:

Once the transplant evaluation has been completed, the test results and the psychosocial interview are presented to The Methodist Hospital Renal Transplant Committee. The transplant committee meets every two weeks to review candidates for transplant, and will decide if you are a good transplant candidate. Pending their decision, you will then be placed on the transplant list so the search for a kidney can begin. If you have a living donor, once your donor is accepted by the Committee, we can arrange a date for your transplant. Sometimes the committee has concerns about items in your evaluation, and they may ask you to "resolve" these concerns before you can be placed on the transplant list.

If your evaluation shows that transplant is not in your best interest, the committee may reject you for transplant.

Making what can be such life-and-death decisions is obviously the stuff of drama, literally. A play called "The God Committee" was staged a few years ago about one such panel. It didn't get good reviews.

In any event, the next time someone warns that President Barack Obama's and Congress's health reform proposals will usher in death panels that will decide who lives and who dies, it might be useful to point out that such panels are nothing new. In fact, they already exist, though by another name.

http://www.npr.org/blogs/thetwo-way/2009/08/health_care_death_panels_arent.html