"But they're cousins! Identical cousins all the waaaaay"

I see (via the Dish) that the National Review has seen fit to call out Sarah Palin for her "death panels" comment. So, credit where it's due. I would love to find the space in my heart to simply say "Strong work, National Review!" without having to add a "... but" to the end. But, there's this:

Anyone who thinks rationing by government is something to be feared has reason to worry about the health legislation being discussed in Washington. The president has many times said that cutting costs is the goal of health-care reform and mused aloud about denying services to the elderly as a method of doing so. It is in this context that the controversy erupted over the proposal, now withdrawn, to pay for end-of-life counseling sessions. It was only reasonable to suspect that this proposal was included to encourage people not to get treatments they otherwise would get. (It’s not as though it moved us toward universal coverage.) The proposal to form a board that could recommend against Medicare payments for various procedures, with Congress required to fast-track its advice, raises the same concerns.

Baleful trends among bioethicists should heighten those concerns. The view that medical care should be withheld from people based not merely on the likelihood of success or the cost but on judgments about the quality of their lives is no longer held only by a fringe. Practices that are at best close cousins to euthanasia have become widespread. And as anyone familiar with the work of Wesley Smith knows, inquiries into patients’ intent are not always fastidious.

First of all, true confession here. I don't know Wesley Smith from a hole in the wall. If this somehow makes my opinions uninformed and thusly moot, feel free to ignore everything else I have to say. However, um... I take some pretty gross exception to the above.

Let's start with the first quoted paragraph. I don't know what they would consider "reasonable," but their implication that doctors would discourage people from choosing end-of-life care they would otherwise want in order to cut costs is rank slander to members of my profession. I have never, in years of working with indigent patients at public hospitals in two major cities, ever once seen a medical provider cite cost as a factor for denying any patient end-of-life care. Doctors who discuss end-of-life care with patients are doing so in order to have the patients' wishes known in advance in order to comply with them as fully as possible. To insinuate otherwise is not, in my opinion, "reasonable."

Further, yes, perhaps those consultations will prevent patients from receiving services that they would otherwise "get." (And yes, perhaps money would be saved.) But are they services that they would otherwise want? A common refrain when discussing end-of-life care is "he/she would never have wanted to live hooked up to a machine." Giving people an honest description of what end-of-life care looks like may prevent them from ending up on the grossly-misnamed "life support," with various machines assuming the function of organs that will never recover. Preventing this for people who don't want it is a good, not an ill. And, again, there is no evidence that anyone has ever, or will ever, try to talk people out of the care they would choose because of cost.

Then there's that second paragraph. "Close cousins to euthanasia"? "Widespread"? What the holy hell does that mean? What is a "cousin" to euthanasia? What is this "widespread"? Somehow I think this is their way of describing Terri Schiavo-like circumstances, in which case I would question both what kind of relative that would be to euthanasia, and how "widespread" those cases are.

Still, lamentable crap aside, I do give the chaps at National Review credit for criticizing Sarah Palin. It's a close cousin to sanity.