Matter of resources, not discrimination
This letter is in response to William Slater's Fence Post letter on Thursday 9/24/08, where he criticizes Dr. Ezekiel Emanuel's comments. Mr. Slater claims that Dr. Emanuel's comments hypocritically and unfairly blamed the Hippocratic oath and would cause discrimination against the elderly.
Dr. Emanuel's comments were based upon the ethics of medical resources. There is a finite supply of medical resources or at least money to pay for the usage of those medical resources. Only a certain limited number of tests and treatments can be performed with those resources.
The issue is that some medical treatments cost exorbitantly more than others, often times several orders of magnitude more. So the ethical issue becomes which procedures do we pay for? Do we pay for the very expensive treatment that saves one person, or do we expend the same amount of resources to save 10 lives?
This is why Dr. Emanuel criticized the Hippocratic oath. The Oath requires that doctors do whatever they can to save their patients, but expending those resources on a single patient could cause the deaths of several other people.
Dr. Emanuel isn't saying that the Oath is bad; he's saying that fulfilling the Oath could lead to maltreatment of other patients, thereby unintentionally violating the Oath itself by trying to uphold it.
This is why Dr. Emanuel's comments about the elderly appear to be discriminatory. The elderly usually require much more care and that care is very expensive, so such care provided to a single elder could be used to equally treat several younger people.
Dr. Emanuel isn't arguing that elders should not be medically treated or that they deserve less attention than the young. He's simply exploring the ethical issues of being a doctor within a larger society and not just in an exam room.
Philip Procento
Vernon Hills