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Bioethicists Counteract Three Healthcare Reform Myths

Janice Simmons, for HealthLeaders Media, August 14, 2009

Bioethicists jumped into the healthcare reform fray this week by issuing three points that counteract three "myths" about healthcare reform. They said "the real bottom line" is that "the current state of healthcare is unethical."

They added that the current proposals debated in Congress "all go a long way towards making healthcare in America more just." Specifically, at the current time, nothing in the current proposals "threatens a patient’s right to choose--a critical feature of an ethically acceptable health care system."

"I think for the first time the field of bioethics has matured enough to the point where not only do we think that we have some interesting thoughts, but we actually feel that there's a responsibility to say what we think," says Eric Meslin, PhD, a member of the Association of Bioethics Program Directors, which represents the leadership of 60 academic bioethics programs across North America.

"When there are obvious errors of fact that are used as sort of instruments of policy deconstruction--instruments of trying to get the public to think something when they're not--that in and of itself is unethical," says Meslin, who is director of the Indiana University Center for Bioethics. "If 60 bioethic center directors can't call that unethical, I don't know what they can call unethical."

The ABPD represents the leadership of 60 academic bioethics programs across North America. The three "myths about the ethics of healthcare reform" they challenged are:

Myth #1: "Health care reform will mean giving up control of my own health care decisions."
They said that the field of bioethics has "long championed the rights of individual patients" to make their own healthcare decisions in consultation with their physicians.

"If we thought the major proposals being considered posed a serious threat to these rights, we would be the first to speak out.” They added, "The right of individuals to make decisions about their healthcare is engrained in the ethics of American medical practice" and that wouldn't change under current reforms under discussion.

Myth #2: "Healthcare reform will control healthcare costs by depriving patients of important but costly medical treatments."
The group said this was "untrue" because the provisions in current healthcare proposals "will increase the likelihood that patients will get quality medical care and decrease the likelihood of medical errors that kill thousands of patients every year."

They said that unethical ways to control costs include "refusing to treat the uninsured or those who have insurance but cannot afford the out-of-pocket costs of expensive treatments that is the status quo."

Myth #3: "Health care reform will deny older Americans medical treatments at the end of life."
They called this "the most pernicious myth of all." They added that "in proposed approaches to reform....a provision [exists] that supports the rights of individuals and their families to make decisions at the end of life by institutionalizing a process for patients and families to express their desires to their physicians and other health care professionals."

This right is "part of the culture of American medicine, defended since the beginnings of the field of bioethics, and supported by case law going back over 50 years," they said. They added that while some opponents of healthcare reform have "twisted both the intent and effect of this provision" and made unsupported claims about how it will push older Americans into hospice against their will and even euthanasia, "nothing could be further from the truth."


Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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