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Are All "Bioethicists" This Hypocritical? Or Just Daniel Callahan?

Posted Aug 28 2009 8:06pm




Daniel Callahan
has spent a lifetime telling the rest of us to spend less on health care, but when it comes to his own health care, well, that's a different story. We should do what he says, and he will do as he wishes. Got that? It's all in Saturday's New York Times.

For the past 40 years, The Hastings Center, co-founded by Callahan, has been conference-ing and seminar-ing on "bioethics." Plenty of people have thought long and hard about ethics over the past few thousand years, of course, and reached many different conclusions, but the Hastings Center was at the right place at the right time. It fill a perceived need for a "new ethics"--that is, mostly free of religion--to deal with complex medical- and technology-related issues in the 20th century. As the Times'Peter Steinfels writes:

Ever since Mr. Callahan began exploring such themes in books like “Setting Limits” (1987), “What Kind of Life” (1990), “The Troubled Dream of Life” (1993) and “False Hopes” (1998) — all published by Simon & Schuster — he has been unjustly accused of favoring something like Sarah Palin’s imagined “death panels.” In fact, he has been a vocal critic of doctor-assisted suicide and other steps toward euthanasia.


And Callahan's newest book echoes his predecessors: "Taming the Beloved Beast: How Medical Technology Costs Are Destroying Our Health Care System,” forthcoming from Princeton University Press. For his part, the Times' Steinfels is sympathetic to Callahan's views--as Steinfels disclosed in the Times piece, he once worked at the Hastings Center.

Others have a darker view of Callahan, Hastings, et al. One such critic is Wesley Smith whose book, The Culture of Death, describes how the "bioethics" movement created its own new political culture, and deeply influenced all of health care policy. It is fair to say that overall, Peter Singer, Ezekiel Emanuel, and the bulk of the professional apparatus that deals with "health care policy" share much of this same worldview.

But back to Daniel Callahan. He is an elder statesman now--literally. And now that he has reached the age of 79, the world, and its health care priorities, evidently looks different to him. Here's more of the Times story:

Still, is there a way to “cool our aspirations,” as he puts it, and gain “a more finite view of what health care is about” without somehow institutionalizing that bureaucratically? Mr. Callahan says he is trying to address such questions in a new book, “Taming the Beloved Beast: How Medical Technology Costs Are Destroying Our Health Care System,” to be published soon by Princeton University Press.

Meanwhile, he suggests that the United States might learn something from Europe, where government budget caps on health care, price controls and far less news media frenzy about medical breakthroughs combine with widespread deference to a more modest view in the medical profession about what constitutes appropriate treatments.

Solutions, he proposes, will involve an interplay between a “well-managed government program” and an “inner spiritual conversion.”

Mr. Callahan, 79, had just returned from the hospital himself. Days earlier, he had undergone a life-saving seven-hour heart procedure. He chuckled at the idea that when the emergency arose, lightheaded and knowing his life could be in danger, he might have exercised consumer choice and “shopped around” for a better deal than the medical center his cardiologist recommended.

And at this point, of course, he could only guess at the total cost of his hospitalization — bigger than a breadbasket, let’s say, and less than $100,000. “As I was in the hospital,” he said, “I thought a lot about this.”


Those last two paragraphs are worth repeating:

Mr. Callahan, 79, had just returned from the hospital himself. Days earlier, he had undergone a life-saving seven-hour heart procedure. He chuckled at the idea that when the emergency arose, lightheaded and knowing his life could be in danger, he might have exercised consumer choice and “shopped around” for a better deal than the medical center his cardiologist recommended.

And at this point, of course, he could only guess at the total cost of his hospitalization — bigger than a breadbasket, let’s say, and less than $100,000. “As I was in the hospital,” he said, “I thought a lot about this.”


A 79-year-old getting an elaborate medical procedure that might have cost upwards of $100,000? Isn't this exactly the sort of over-treatment that the health care rationers oppose? Sure it is. But it's different when it's them.
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