PROTECTING PATIENTS FROM
HEALTH-CARE ADMINISTRATORS
WHO MUST SAVE MONEY
FINANCIAL MOTIVES FOR CHOOSING AN EARLIER DEATH
Every health-care system, whether public or private,
has administrators who are responsible for managing the health-care
resources
to do the most good for the most people.
These administrators do not usually know the
patients personally.
They are looking at computer screens
that show the amount of medical resources already spent
on patients whose names or identity numbers mean nothing to the
administrators.
When these administrators are government officials,
they are making sure that the tax-payers' money devoted to health-care
is being spent as wisely as possible.
Billions of dollars saved in questionable terminal care
can be redirected toward pre-natal care for pregnant women,
who would otherwise be at risk of producing defective infants,
who will cost the tax-payers even more for their life-time care.
When these administrators are executives of
insurance companies,
they are responsible for limiting the amount of money paid out for
health-care
so that the stock-holders will have a larger profit at the end of the
year.
If they are too generous with the cash in the vault,
they will be replaced by other executives who can manage the money
'better'.
When the administrators are hospital executives,
they know that there are only a certain number of beds in the hospital
and in the intensive care unit.
When the demand for care exceeds the supply,
they must decided which patients to shed
in order to achieve the greatest good for the greatest number of
patients.
This sometimes means taking an intense-care bed
away from an elderly dying patient
in order to devote those same staff and other medical resources
to saving the life of a young mothers of three children.
Administrators must operate according to abstract
principles
rather than personal feelings.
And many of those abstract principles are financial in nature:
What is the best use of the medical resources at my disposal?
Since the resources will always be limited,
choices must be made between continuing to treat patient A
and allowing patient B to die.
PROTECTING
AGAINST HEALTH-CARE ADMINISTRATORS
Careful safeguards can help to prevent premature
deaths motivated by money.
The safeguards that would counter-balance the financial incentives
call for the considered judgment of persons
who are not subject to the same financial pressures as health-care
administrators.
Here are eight safeguards that will be most
effective
against cost-cutters,
listed in order of effectiveness, beginning with the most powerful:
PHYSICIAN'S
STATEMENT OF CONDITION AND PROGNOSIS
REPORT TO THE
PROSECUTOR BEFORE THE DEATH TAKES PLACE
CIVIL AND
CRIMINAL PENALTIES FOR CAUSING PREMATURE DEATH
REQUESTS FOR
DEATH FROM THE PATIENT
INFORMED
CONSENT FROM THE PATIENT
UNBEARABLE
SUFFERING
ETHICS
COMMITTEE REVIEWS THE LIFE-ENDING DECISION
STATEMENTS FROM
ADVOCATES FOR
DISADVANTAGED GROUPS
IF INVITED BY
THE PATIENT AND/OR THE PROXIES