Dr. Zeke Emanuel, essentially a smart,decent guy, has views distorted by both Left and Right.

****The distortions on the Right are unnecessarily perjorative of Emanuel himself; the distortions on the Left are likely to be dangerous and inimical to American principles preferring the individual to the collective.**** In a New York Post opinion article, Ezekiel Emanuel was described by Betsy McCaughey as a "Deadly Doctor." The article, which accused Dr. Emanuel of advocating healthcare rationing by age and disability,...****He does suggest this in the context of scarce organ transfer but his restricted position will likely be taken out of context by a cost-saving government, as it has been in the U.K.****Sarah Palin said that Dr. Emanuel's philosophy was "downright evil" and tied it to a health care reform end of life counseling provision she called a "death panel"...****The proposed counseling is not mandatory but not voluntary, either (and not specifically associated with Dr. Emanuel)in the sense that patients who neither request it nor specifically reject it will... get it. Doctors will be required to propose such counseling, and will be paid for it and the patient would pro-actively have to reject it. One would hope ( and expect ) that doctors would not prefer euthanasia as a recommendation (nor would it be legalized as a result although others might follow Oregon in this regard.)The anticipated discrimination against Down Syndrome children would emerge from OTHER panels than the end-of-life ones.**** Ezekiel Emanuel wrote an article for The Hastings Center Report in 1996. In this article, Emanuel wrote, "The social or, in the economist's language, the macro level entails the proportion of the gross national product (GNP) allocated to health care. The patient, or micro, level entails determining which individual patients will receive specific medical services; that is, whether Mrs. White should receive this available liver for transplantation. Finally, there is an intermediate level called the service or medical level that entails determining what health care services will be guaranteed to each citizen. These socially guaranteed services have been called 'basic' or 'essential' medical services … So rather than risk the bankruptcy of having nearly every medical service socially guaranteed to all citizens, Americans have been willing to tolerate a system in which the well-insured receive a wide range of medical services with some apparently basic services uncovered; Medicare beneficiaries receive fewer services with some discretionary services covered and some services that intuitively seem basic uncovered; Medicaid beneficiaries and uninsured persons receive far fewer services … Without overstating it (and without fully defending it) not only is there a consensus about the need for a conception of the good, there may even be a consensus about the particular conception of the good that should inform policies on these nonconstitutional political issues … Substantively, it suggests services that promote the continuation of the polity-those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia. A less obvious example is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason."[15]****While Emanuel is revisionist in his interpretation of the Hippocratic Oath, which traditionally applies to individuals rather than taking the utilitarian view that the benefit to society trumps this, it is an arguable position even if one that does not accord with American emphasis on the individual as opposed to the state. The misreading of the second part of his statement is unfortunate. Yoda reads him to say, NOT that care should be withheld from children with learning disabilities but RATHER that they should get extra care to be able to contribute as much as possible to society. One suspects that Sarah Palin is right, however, in thinking that Down Syndrome children would NOT be preferred under an Emanuel regime.****McCaughey said, "Translation: Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy."****She's right about grandmother but not clearly about the child.**** In 2009, he co-wrote another article on a similar topic, "Principles for allocation of scarce medical interventions" in the journal The Lancet.[16] The article advocates a health allocation system termed the "complete lives system". Ezekiel said, "Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles."
According to Betsy McCaughey, Emanuel "explicitly defends discrimination against older patients: 'Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years'"...****This is likely to be implemented by the Democrats as discrimination against the aged in order to save money (25% of Medicare goes to the last year of life )as it has been in Britain and Canada where the cost of anything is divided by the years of useful life to get a weighting factor.Moreover, a careful reading of Emanuel indicates that even he argues it is NOT invidious IF AND ONLY IF instituted prospectively exclusively for newborns (who can experience a full, productive life cycle under his system ) rather than applied to present adults and elders where, even by his lights, it IS invidious. **** He says, "As far as rationing goes, it's nothing I've ever advocated for the health system as a whole, and I've talked about rationing only in the context of situations where you have limited items, like limited livers or limited vaccine, and not for overall health care."[...*** While Emanuel may be a "good guy", the bureaucrats of Britain's National Health Service, and Canada's system interpret QualiYears to weight expensive care to seniors less than care to younger. (Emanuel's priority curve is "interesting" --if controversial--since it gives low weight to children below age 15, rises to maximum at ages 15-50 and drops increasingly with age. Another Obama adviser, Prof. Peter Singer, doesn't consider children to be fully "human" until they reach age of about two years. His criterion is that a being has to recognize the concept of "tomorrow" before achieving "personhood." Presumably Singer, who equates animal rights with human rights, would approve of abortion blending into infanticide.)It seems clear, moreover, that Barack Obama does not approve of the fact that his own grandmother was given a hip replacement shortly before her death. He says that he "would have paid for it personally because she was his grandmother" but he was already a millionaire at the time and could have done so had he truly objected on principle.****