The Fable of the Death Panel

Chris Sanchez slowly opened his eyes and sat himself upright in his chair. Chris was angry with himself for having dozed off. This was probably the most important day of Chris’ life and here he was dreaming again – the same old dream, 2009 just before the world changed forever. It took Chris months and all the connections that he could muster for him to finally get an appointment with the Department of Life Preservation, the Terminators, as Chris liked to call it. When 2020 rolled around, Chris had just turned 72 and received a very unwelcome birthday surprise, a myocardial infarction. He was actually lucky with the heart attack in that he survived despite the fact that Life Preservation allows only minimal intervention for someone with a medical profile like his.

Chris was fully awake now and turned his attention to the polite little balding man with the bushy gray black mustache sitting in front of him. Chris didn’t get the man’s name, but that didn’t really matter. He watched the man very carefully review Chris’ request for a follow-up cardiac procedure on the four screen workstation that looked like the machines that turn of the century day traders used. Chris saw that one screen had a neat summary of the cardiac event; the second screen displayed Chris’ profile with rankings relative to other people requesting the same procedure. This screen and its information was in accordance with the Life Preservation Act of 2010 which basically stated that limited medical resources were assigned on a priority basis. The factors determining the priority were never disclosed publicly being classified by the government for reasons of national security. The computer that the little bald man was using was programmed with the top secret algorithm that allocated medical resources. Chris, of course, didn’t know this.

As much as he tried, Chris couldn’t see screens three and four where baldy had been processing his request which had just finished now. Now that the request execution had completed, baldy was satisfied with the results and turned to Chris to discuss his request. Before barren head could open his mouth, Chris started, “I want you know that it’s almost twenty years to the day when my mother had a heart attack similar to mine. She was exactly the same age as I’m now and she had no problem getting all the treatment she needed. She’s still around now. In fact she came along with me and is sitting in the waiting room.” Baldy was taking all this in and nodding tactfully and responded gently, “We know all about your mother. The fact that she had an MI at 72 and two subsequent heart attacks was considered when processing your request.” Seeing that he wasn’t getting anywhere, Chris started getting hot under the collar and added, “You know it’s weird that my mother is 92 and she’ll outlive me. You’re not going to approve treatment. Are you?” Baldy, still cool and calm, answered Chris with a warm understanding smile, “Dr. Sanchez, you should know better than anyone else that the government’s program is all about preserving life and that each citizen must do his part for the betterment of society. You know, of course, that most people aren’t allowed to question the department’s decisions.” Seeing that Chris still wasn’t accepting the department’s decision, Chris’ host, now with a dour look on his face, added sardonically “Doctor you really surprise me. You were one of the staunchest supporters of Life Preservation! OK, OK! Let me try to process your request one final time.”

Baldy was busy working on screens three and four again and Chris’ mind started wandering back again to when it all started. In the years leading up to 2009, Dr. Christopher J. Sanchez was an internist and assistant director at a major US research hospital. He was always a strong patient advocate and did everything in his power to provide the best medical care not only his own patients but also for anyone that he found out about needing medical help. In short, Sanchez was one of the good guys. 2009 ushered in many changes. Probably the most astounding dealt with the new reality in medicine and many people became concerned that the scene that was now unfolding was a serious possibility. Sanchez was one of them, but he did a lot more than just worry about what was going to happen to his patients and all those that depended on him.

In mid 2009, Dr. Sanchez decided to don yet another hat to his ever growing collection and singlehandedly launched the biggest patient advocacy campaign in history. He became a hero, but that’s not what he was after. He wanted to make sure that no patient would be denied medical treatment ever, no matter what the situation was, no matter what the cost. Simple, straightforward idea, nothing could go wrong, but Dr. Sanchez was not taking any chances. He met many times with key members of Congress and many of his influential colleagues to make sure that any provisions that finally became law clearly considered the patient’s interest first.

The latter half of 2009 was the busiest time of Chris’ life. He attended to all his medical duties and hospital administrative chores, as well as running a very effective campaign with what seemed a very obstinate and sly Congress. By early 2010, Dr. Sanchez’s efforts bore fruit in the form of the Life Preservation Act of 2010, known to some as the Sanchez Bill. At first Life Preservation was hailed as the universal panacea, the cure to the healthcare woes that had been ailing this country for such a long time. Chris even had to add appearances on talk shows and late night entertainment to his other activities.

It didn’t take long for Chris and the rest of America to figure out that they had been suckered by Congress and that the structural components of Life Preservation was fool’s gold. Upon minute examination of the implementation components, which Congress craftily concealed, it was discovered that Congress’ intention was to preserve one life at the expense of another. This was healthcare rationing par excellence. Chris became a national pariah overnight and no longer could do anything about the monster he helped to create. The people were furious and Chris was not the only one who fell from grace. Americans booted almost every member of Congress involved with Life Preservation, but the new Congress still didn’t have enough votes in 2011to override the Presidential veto; so the misery continued.

Relief finally came when a new President took office on January 20, 2013. This inauguration day was like no other in America’s history. The President dispensed with all the inaugural activities and made the shortest inaugural address ever, “Americans are facing great evil. There will be time for speeches later. Now we need to get to work.” With that, Congress and the President worked around the clock and delivered the repeal of the Life Preservation Act a scant two days later on January 22, 2013. People all over the country threw parties and rejoiced even though the country suffered the worst January in more than a century. The times were sure pretty crazy.

It may have been a sheer coincidence that Life Preservation was repealed forty years to the day after the Supreme Court handed down the Roe v. Wade decision on January 22, 1973 or maybe it was a harbinger of the events that unfolded next. With the President’s signature barely dry on the repeal of Life Preservation, Congress began to dismantle all the Life Preservation machinery put into place by the previous administration. Within weeks, one Audley Talke, a regional director at Parental Planning, challenged the repeal of Life Preservation. Talke had a rare cancer and was one of those who had received treatment under the terms of the now defunct Life Preservation Act. The treatment was ridiculously expensive and he should not have been covered given his profile. But, Talke was different. He had the right connections through his position with Parental Planning and somehow finagled treatment. Talke had received treatment starting in mid 2010 right after the Life Preservation apparatus was put into place, but Talke’s doctors decided to stop this treatment on January 22, 2013. This was no coincidence (?). The doctors determined that the treatment wasn’t effective and was actually doing harm as well. That didn’t stop Talke from bringing a lawsuit against the US government, claiming that his treatment ended with the repeal of the Life Preservation act. He enlisted the formidable legal machinery of Parental Planning and within weeks the Supreme Court was looking into Talke v. United States. It seems that whenever the Supremes hear a case, Parental Planning is somehow in the thick of things.

Justice John Marshall Burger-Frye is a cantankerous old man. He’s a contrarian. If the country says black, he’ll say red and what’s worse, he’ll rule red simply because he can get away with it. He’s in his post for life and no one can challenge him save the other Justices on the bench. Burger-Frye also has a creative flare, pulling out judicial precedent from thin air and basing his decisions on the stuff he makes up. Like so many supreme justices that sat before he did, Burger-Frye had no problem legislating social policy if it suited his fancy. He had been dabbling with the bioethical principles behind legalized euthanasia, especially Peter Singer’s teachings in which Singer proposes a new morality based on Singer’s notion of “quality of life”. When Talke v. United States came before him, Burger-Frye was ready. It didn’t take the justice long to read “quality of life” into the constitution. The rest is history. The people be damned, Congress be damned, even the President be damned. The Supreme Court has ruled. Life Preservation became law that could no longer be overturned.

Chris had his familiar dream again, except that this was no dream. It was everyone’s nightmare. As Chris was waking, he heard the little balding man with the bushy gray black mustache say politely, “Dr. Sanchez. Do wake up. I have the final results of your inquiry…”

The dramatic saga of Dr. Christopher Sanchez is obviously a fictional story, but serves as a good backdrop for serious discussion. There are quite a few points here that could be examined in greater detail, but I’d like to focus on one point – the most obvious – the Death Panel. Some people may argue that this is baldy and his cohorts at the Department of Life Preservation and that “Death Panel” is a fictional construct which lives in the ghoulish dominion of this story. The truth, however, is more gruesome than any fiction could ever be. Even if this was not a fable but was really a report from the year 2020, the men and women of an organization like Life Preservation are merely public servants carrying out their orders. (Yeah, that sounds familiar). There is a real Death Panel here and it’s not imaginary – yes, in the year 2009. Actually this Death Panel has been around for quite a while. This panel is deadlier than any other mere group of bureaucrats could ever be. Yes, we’re talking about those men and women in their black robes that sit unchallenged judging all – the Supreme Court.

How can I say this? A little trip back in time with just a few quick stops will convince you. You can check the facts in many American history books or on the internet. At the nation’s founding , the architects of the constitution constructed a system of government based on three coequal components, each providing a check against either of the other two usurping power. This is the stuff of junior high school, except that this balance was soon broken in the landmark case Marbury v. Madison when Supreme Court justice John Marshall pulled a fast one. It was 1803 and he forever seized power for his court to negate the judgments of the other two branches, and the will of the people to boot. It was a mere fifteen years after the ratification of the constitution and our nation found itself at the mercy of a judicial dictatorship.

Fast forward to 1857 to one of the darkest times in America’s history and we find that the Supreme Court had grown more powerful with each case they considered. By this time the Court had already invalidated numerous acts of Congress and it became clear that as far as the court was concerned the people’s will didn’t count anymore. In the Dred Scott decision of 1857 the Court really showed its true colors by reading into the Constitution whatever it wished. The Dred Scott case was complex indeed. He was a slave that had been taken by his owners for an extended period to Illinois, a free state. He traveled later to the Wisconsin Territory (present day Minnesota) in which the federal government outlawed slavery under the Missouri Compromise of 1820. By all rights Scott should have become a free man, yet he failed to win his freedom in a series of lawsuits spanning ten years. The case was finally decided in early 1857 by the Supreme Court. Not only did the court strike down the Missouri Compromise by ruling that it was unconstitutional, but Scott was denied freedom by the Court's decision also. Why? The court concluded that because Scott was black, he was not a citizen and therefore had no right to sue. The Court went on to say that the framers of the Constitution believed that blacks "had no rights which the white man was bound to respect; and that the Negro might justly and lawfully be reduced to slavery for his benefit. He was bought and sold and treated as an ordinary article of merchandise and traffic, whenever profit could be made by it.” Unbelievable! You won’t find anything remotely close to this in the Constitution or the Declaration of Independence with its bold “All men are created equal.” So, how did the 1857 court deal with the Declaration? Totally out of control. Referring to the language in the Declaration of Independence that includes the phrase, "all men are created equal," the court reasoned that "it is too clear for dispute, that the enslaved African race were not intended to be included, and formed no part of the people who framed and adopted this declaration. . . ."

Justice didn’t matter. The Constitution wasn’t the court’s guide either. The court bent the Constitution any way it wanted and in 1973 it made the ultimate breach. In that year the court decided Roe v. Wade and became the Supreme Death Panel. Yes, the court was concerned about all the difficulties that some women were having when they became pregnant unintentionally. What did the court do with all this compassion? Citing population control among other abhorrent rationalizations, it proceeded to strike down all existing abortion laws, ruling that a woman and her doctor could kill her unborn child. Does that statement sound excessive? Actually, anyway you slice it, that’s exactly what is happening. So why were 50,000,000 babies killed since 1973 and not protected under the Fourteenth Amendment which provides “nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws”? With legalese conniving the Purveyors of Death found the same convenient answer that the Dred Scott court used and said that the unborn is not a person – go kill it.

The Death Meisters weren’t quite through yet. In 2000 they just felt the great urge to overturn the Nebraska law banning partial birth abortions, a most gruesome practice. Oh, you’re not sure what partial birth abortion is? Let me demonstrate. Close your eyes. Imagine that you are in an elevator and the elevator door has closed. Below where you are standing, something has opened a large slit in the floor and grabs you by the legs. This monster, that’s what it has to be, sticks up a tentacle and grabs you by the legs. With tremendous force, it pulls you toward it through the slit. You are struggling to stop this thing but there’s nothing that you can do. The monster is way too powerful. With most of your body through the elevator opening, the monster suddenly reaches into the slit again with another tentacle, but this one has a razor sharp claw at its end. The tentacle’s swift movement ends as the monster rips into the back of your head and cuts a gaping hole there. You’re probably dead by now, but the monster makes sure and uses that multi-purpose tentacle to suck out your brain through the hole in your head and pull the rest of your limp body through the slit.

[ On two separate occasions President Bill Clinton vetoed bills passed by Congress which were designed to ban the inhumane partial birth abortion procedure. Not deterred, Congress passed yet another ban on this brutality, but this time with George W. Bush at the helm, the ban became law. How did candidates Hillary Clinton and Barack Obama respond to this law during the 2008 campaign? Both candidates expressed dismay that the law diminished the ability of a woman to kill her child, er right to choose. I definitely don’t want to get on an elevator with either Clinton, or Obama for that matter. ]

In conclusion, now that the Supreme Court has tasted blood, how long will it be until it makes euthanasia the law of the land?

Before Carthago delenda est we need dare justicia ad judici.