Senilicide: Are We There Yet?

SENILICIDE: ARE WE THERE YET?

By

Dr. Jimmie R. Applegate

Rationing health care for the elderly is one, if not the gorilla in the room, of the trade-offs to implement fully affordable, universal health care for all living in the United States; that is except for the elderly.  The end result of rationing health care for the elderly is senilicide, or sacrificing health care for Americans 75 plus years old to benefit the younger more productive members of society.  This ethical dilemma has challenged society for years.

According to Andre and Velasquez in Aged-Based Health Care rationing (http://www.scu.edu/ethics/publications/iie/v3n3/age.html), Euripides wrote in 500B.C.

“I hate the men who would prolong their lives

By foods and drinks and charms of magic art

Perverting nature’s course to keep off death

    They ought, when they no longer serve the land

          To quit this life, and clear the way for youth.”

If you are elderly are you prepared “to quit this life, and clear the way for youth”?  As callous and as selfish as it may sound, I am not! 

What medical care are the elderly being asked to forego, and who is advocating rationed health care for the post 75 year old Americans?  “The U.S. Preventive Service Task Force recommends against routine screening for breast, colorectal, and prostate cancer at age 75 and beyond and it advises against cervical cancer testing after 65…”  Dr. Otis Brawley, Chief Medical Officer at the American Cancer Society said, “the overwhelming majority of folks over 75 should not be getting these screening tests…this is an example of waste”.  (http://yourlife.usatoday.com/health/story/2011-12-12/Many-elderly-screened-for-cancer-despite-risks/51846678/1)  Brawley also wrote “The truth is many Americans cannot afford adequate health care, and health care is rationed in the U.S.  While many do not get the health care they need, some are actually harmed by overconsumption of unnecessary health care. These Americans are treated outside of established guidelines and get unnecessary procedures and take unnecessary medications”. He appears willing to substitute one form of health care rationing for another.  Brawley is not alone.  On December 13, 2011 CBS reported Dr. Keith M. Bellizzi said, “At a minimum in order to see any benefit of screening, you would want your patient to have a life expectancy of more than five years.

Daniel Callahan argued in his 1987 book titled Setting Limits: Medical Goals in an Aging Society that no federal dollars should be paid for life extending medical care for patients beyond 70 or 80. In other words, the elderly should receive only elementary pain relief treatment.  Such age based health care rationing is justified by claiming the elderly have lived a normal, natural life span and are taking from society while younger individuals are in the prime of their productive lives and are contributing to society.  Said another way, the elderly unfairly burden society because they “cost” society more to be kept alive than they contribute to society.  This concept of “collective salvation” sacrifices health care for the elderly for the salvation of the collective, AKA society.

As if the current costs of health care are not sustainable, the implementation of President Obama’s The Patient Protection and Affordable Care Act, or ObamaCare, will exacerbate health care costs for all by adding 47 million or more individuals who lack health insurance to the federal dole.  How will this increase be paid for?  Charlotte Allen (http://articles.latimes.com/2009/jul/05/opinion/oe-allen 5],  relates the story of the man who questioned the amount of health care his own grandmother received.  She wrote, President Obama gave us a clue to his thinking when he “questioned the appropriateness of a hip replacement that his grandmother had undergone after breaking her hip shortly after being diagnosed with terminal cancer.”  Obama even suggested how such decisions should be made; i.e., “not by patients or their relatives but by a group of doctors, scientists, ethicists [Independent Payment Advisory Board] who are not part of normal political channels”.  These comments speak volumes about the intentions of the man who made them.  Just think, as this man evidently does, how much Medicare funding would be available for redistribution to the younger and more productive if medical care for the elderly were denied or rationed thus guaranteeing they would die earlier.  When the man making those statements and using his own grandmother’s health care to argue for rationing health care for the elderly--collective salvage-- is the President of the United States, senilicide is well on the way.

When the POTUS is willing to sacrifice his own grandmother and the elderly by rationing their health care so millions of youthful American citizens and non-citizens can be added to his health care program, the elderly should enter the New Year with their eyes open and with New Year’s Resolutions they will work to implement in November 2012.  Their access to physician and patient determined health care when they reach 65 plus depends on it.