Start Date: September 28, 2023
I have been posting to this blog for just about a year now. While some issues are point in time observations, others are part of ongoing societal issues. My post “Be Careful” [1] in January 2023 was about the perils of government provided “free” healthcare. The first flaw being that it cannot be free in the collective sense. The second concern in America is the example of the Veterans Administration. Also there are anecdotes of Europeans waiting over a year for less than critical procedures such as joint replacements. But if none of that seems chilling, the discovery of government induced assisted suicide is more than a little shocking. It seems that one way for bureaucracies to deal with the challenge of expensive health issues is to simply eliminate the patients.
In Canada, Belgium, and the Netherlands the victims/candidates include depressed young people, women with anorexia, and lonely elders who are reminded of the space they are taking and the cost of their care. A disabled man who couldn’t find affordable housing and feared homelessness in Canada applied for “Medical Assistance In Dying” (MAID). A veteran and paralympian has been requesting a wheelchair ramp so that she can enter her home without crawling. The health system responded that she could consider suicide. In British Columbia a 37 year old single woman with a rare disease lost her primary physician and was unable to obtain palliative care. She was persuaded to not only end her life prematurely but to participate in an advertising campaign about embracing the beauty of dying. Her friends suggest she was simply exhausted from trying to get help from the socialized medical system. [2]
Lest you dismiss these as anecdotes, a Canadian reporter found that nearly 5% of death certificates in some provinces indicate assisted death. [3] There is thought of expanding eligibility to adolescents, with consent of a mentor, and deformed babies who can neither request nor consent to death A UK study discovered that the Netherlands is euthanizing people for autism and intellectual disability. [4]
A common theme seems to be that the patients were either lacking a strong advocate to protect them from the socialized health system or that their depression was manipulated. Sadly “free” health care lends itself to balancing the budget by way of expediting the costlier cases to a more affordable termination.
Still, Americans often have utopian perceptions of the British National Health Service (NHS). So it is worth noting that the NHS has recently raised the ante even beyond providing what Canada calls “assistance in dying” to actually pushing a patient off of the proverbial ledge.
A young woman with a fatal disease was hospitalized for treatment. She knew the prospects. She was 19, ergo an adult. She was not in a coma. She was in full control of her faculties. She was conscious. She wanted to continue receiving her treatments, including dialysis. She explained
“I want to die trying to live. We have to try everything.” [5]
But the NHS said “No.” They went to court to end her treatment against her wishes. Please let that sink in. The NHS, which is effectively the sole provider of health care for British citizens, went to court to be allowed to withdraw life support from a conscious competent teenaged adult A-student who had stated her desire to fight for a chance at living longer. Her doctors deemed her delusional for not giving up on her life. Despite two court appointed psychiatrists assessing her to be capable of making decisions about her care, a judge ruled her to be mentally incompetent to make decisions or to instruct her lawyers. [6] Were she fighting to die one can imagine every possible check and intervention being pursued. But she was fighting to retain life support only to have the court rule against her for not being willing to just roll over and die. Her fate was sealed by an entity known as the “Court of Protection”, a body which has the power of deciding that her best interests were served by withdrawing treatment and dying as promptly as possible.
If this wasn’t enough of a nightmare the government took it even a step further. The family had hoped to raise funds privately to seek alternate care elsewhere. The judge took an act that I find inconceivable as an American. I hope I never have to consider it happening in this country. The court imposed what was in effect a gag order requested by the hospital. With the wildly ironic label of “transparency order”, a judge mandated the family not publicly identify their daughter, themselves, or the hospital. Doing so would put them in contempt of court.
So the NHS won. On September 12, 2023 the patient referred to only as “ST” died. No further need to spend money on life support. Her family is now allowed to say her name. She was Sudiksha Thirumalesh, a petite beautiful bright student. Her parents statement is: “We did not look for this fight, this fight came to us from a ”system” that too readily gives up on life. We were brutally silenced, intimidated, and taken to court in the hour of our need.” [7]
Between the mandated withholding of life support and court gag orders one wonders how many other “ST”s has the NHS anonymously delivered to the morgue, with families terrorized into silence. All accomplished with the power of the Court of Protection deciding what is best. Or maybe what is cheapest. Exactly whom are they protecting?
Mercifully the United States hasn’t reached this level of nihilism. Yet. But again I ask that you to be careful what you ask for. It will happen little by little. When President Biden claimed to lower Medicare drug costs he didn’t mention that it involved severely limiting the coverage of a new Alzheimer’s drug so that it only will apply to those in clinical trials. [8]
Recently the Wall Street Journal reported that the Centers for Medicare and Medicaid Services (CMS) is limiting coverage for blood tests used to monitor transplant patients for signs of organ rejection. They deemed it too costly. Providers have already seen a 20% cutback in testing. [9]
With the existence of a private health system there is still the option that some will be able to pay for the testing out of pocket and others can resort to public fundraising without fear of contempt of court citations. In my original post I noted that a wealthy pop singer from Canada moved his family to the United States as soon as his young child was diagnosed with cancer. With no private sector governments make all the decisions. Drug companies, medical device manufacturers, and testing companies may simply cease to maintain a product or service that is not on the government’s approved list, as there will be no source of revenue. But government funded programs generally limit approval to standard treatments and medications. By definition no breakthrough drug, innovative procedure, or new diagnostic technology will be “standard” when still in development, a process that costs billions of dollars and takes many years. So government-only health care means largely eliminating a better future. If you have a rare condition with no cure then be it ever thus.
Assuming the best of intentions, it all began with a desire to expand access to health care and reduce the suffering of the imminently dying. Then came governments and courts and budgets for things are not at all free. Gradually the living but incurable, the chronically ill, the disabled, the no longer productive, all became extensions of near death. After all we are all going to die someday. If you are on the government dole, sooner maybe be preferable to later. Yes insurance companies try to cut costs. But have you ever known one to go to court to deny your family the right to fundraise for your care elsewhere?
So before you embrace the European or Commonwealth model and abandon your right to free speech in exchange for free care, you need to ask yourself if you truly feel comfortable letting the value of your or your child’s life be weighed by the scales of justice in the “Court of Protection”.
REFERENCES
[1] https://notcommonsense.com/be-careful/
[2] Hopper, Tristan, “ Woman featured in pro-euthanasia commercial wanted to live, say friends”, December 5, 2022, https://nationalpost.com/news/canada/woman-euthanasia-commercial-wanted-to-live
[3] Subramanya, Rupa, “Scheduled to Die: The Rise of Canada’s Assisted Suicide Program”, October 11, 2022, https://www.thefp.com/p/scheduled-to-die-the-rise-of-canadas
[4] Nerozzi, Timothy. “Netherlands euthanizing autistic and intellectually handicapped people, researcher finds Intellectual disability played a significant role in the suffering of 21% of those euthanized”, June 28, 2023, https://www.foxnews.com/world/netherlands-euthanizing-autistic-intellectually-handicapped-people-researcher-finds
[5] Roberts, Michelle, “Critically ill UK teen in legal fight with NHS”, BBC, September 1, 2023, https://www.bbc.com/news/health-66673511
[6] Parks, Kristine, “UK court rules teen with rare disorder incapable of making decisions about care despite begging to live”, September 2, 2023, https://www.foxnews.com/media/uk-court-rules-teen-rare-disorder-incapable-making-decisions-care-begging-live
[7] Bains, Inderdeep, “Teenager Sudiksha Thirumalesh who bravely fought doctors’ attempts to withdraw her life support until her dying moment can FINALLY be named as judge lifts gagging order”, Daily Mail, September 22, 2023, https://www.dailymail.co.uk/news/article-12549597/Teenager-19-bravely-fought-doctors-attempts-withdraw-life-support-tragic-death-battled-abroad-experimental-treatment-FINALLY-named-judge-lifts-gagging-order.html
[8] Aboulenein, Ahmed, “Biden Medicare cost victory due mostly to Alzheimer’s drug change”, Reuters, September 27, 2022, https://www.reuters.com/world/us/biden-medicare-costs-victory-due-mostly-alzheimers-drug-change-2022-09-27/
[9] WSJ Editorial Board, “Biden’s Organ Transplant Rejection, Medicare rations blood tests to save money, but it will hurt patients.”, Wall Street Journal, September 27, 2023, https://www.wsj.com/articles/organ-transplant-blood-tests-medicare-biden-administration-moldx-c6b14784