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Death Panels: Sarah Palin Was Right, Sort Of

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In 2009, former Alaska governor and vice-presidential candidate Sarah Palin raised the kind of ruckus she’s known for with her comment on the then-notional Affordable Care Act, aka “ObamaCare.” In a Facebook note, she wrote:

“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide … whether they are worthy of health care.”

Palin’s aim was rather off (she was grousing about an ACA provision allowing Medicare to reimburse patients for voluntary “end of life care” consultations), but as the world watches the unfolding tragedy of 11-month-old Charlie Gard’s terminal illness in the United Kingdom, “death panels” are suddenly newsworthy again. Palin’s core worry was relevant then and it’s relevant now. It’s also non-controversial, or at least it should be.

Healthcare is a “scarce resource,” by which I mean that there is more desire for it than there are doctor hours and hospital beds and bottles of medication to fulfill all that desire. In any healthcare system, therefore, care is going to be rationed. If people want or need ten units of health care and there are only nine units available, someone is going to lose out.

Rationing can be handled in a number of ways: Pricing in an entirely free-market system, quick triage in an emergency situation with multiple victims presenting varying levels of injury,  alleged experts in systems ranging from the bureaucratic mess of an “insurance” system in the US to the “single-payer” systems in the United Kingdom and other countries. While I favor a free-market system, my intention here is not to argue that point, but rather to point out that “death panels” are inherent in the overall situation.

While it’s heartbreaking that young Charlie likely faces death from mitochondrial DNA depletion syndrome, and soon,  that would likely also be true in the US. Most insurance companies would balk at paying for the experimental treatment his parents seek, and their ability to raise funding for it through charity is not the usual course of things.

The instant problem here is not that a panel of alleged experts at London’s Great Ormond Street Hospital or at some other level of the UK’s National Health Service reached the painful decision to allocate the scarce resources at their disposal to someone or something other than prolonging Charlie’s life.

The problem is that, having taken that decision, those experts demanded that Charlie’s parents accept their authority in the matter, and successfully fought them in to court to prevent them from seeking treatment for him elsewhere.

While it so happens that Charlie is an infant whose parents are claiming the rightful authority to make that decision, the “death panel” precedent here could just as easily be applied to a terminally ill adult: “We can’t treat you any more, and we’re not going to let you seek treatment elsewhere either.”

That way lies the darkest evil and savagery. Free Charlie Gard.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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Op-Eds

Circumcision: One Woman’s Piercing Commentary

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Baby with fake cheek piercing

When Enedina Vance posted a photo of her smiling baby with a pierced cheek on Facebook, she expected — and wanted — a reaction. She probably didn’t expect the reaction to be so vehement.

She received death threats. Some commenters claimed to have called government “child protective services” to come take the child away from an “abusive” mother.

When Vance revealed that the photo was fake (no, she hadn’t really had her child’s dimple pierced) and intended as social commentary, the hate level seemingly went up rather than down. Her target topic: Circumcision. If her goal was to fire up debate on the issue, mission accomplished.

Statistics vary by area and timeframe, but  the bottom line is that more than half of American male infants are subjected to circumcision, a painful genital mutilation ritual in which part of the penis (the foreskin) is amputated.

In some cases, the ritual is religious. In America the justification usually goes back to the Old Testament covenant between God and Abraham. Religious Jews practice circumcision, and many Christians, because our religion is an offshoot of Judaism,  consider it non-controversial (we’re not so tolerant of Muslim equivalents as applied to female infants).

In most cases, the ritual is medicalized — conducted at a hospital, by a doctor, based on one or more sketchy claims of health benefits. That started in the 19th century when masturbation was considered unhealthy and circumcision was thought to minimize it. In recent years, circumcision advocates cite research claiming benefits from reductions in penile cancer (which only affects 1-2 males per 100,000 anyway) to reductions in HIV transmission (that claim remains in dispute) and so forth.

If I started a new religion which required its adherents to cut each infant child’s left little toe off, those adherents would go to prison if they tried to live their faith.

As for the medical excuses, hey, I know how we can eliminate carpal tunnel! All we have to do is amputate each newborn’s arms right below the elbows! I’m kind of guessing that suggestion’s not going to fly with the American Medical Association.

The reason — the ONLY reason — infant male genital mutilation is tolerated (even justified and promoted!) in America is that it’s a millennia-old custom, “grandfathered in” to our culture. If we set aside the age of the habit, it stands revealed as nothing more than a brutal assault on a helpless victim.

Let’s cut circumcision out.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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Op-Eds

Our Paranoid Society is Too Hard on Kids — and on Parents

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In the latest sign that America has gone stark-raving nuts at the expense of its parents and children, the Rochester, New York Democrat & Chronicle reports that a “mother faces child endangerment charges for letting her 10-year-old hang out in a Lego Store while she shopped elsewhere” in the same mall.

Not a week goes by without a report of parents getting arrested, or having their children seized by social workers, for the “crime” of letting them walk to or from school or a local playground.

Despite the fact that violent crime — including crimes against children — has been on a downward trend since the early 1990s, we’re constantly propagandized about the danger of letting kids out of our sight.

Despite the fact that parents these days almost uniformly educate their kids on how to respond to being approached by strangers (don’t talk to them, don’t get in cars with them, move away from them, scream bloody murder if they touch you), the conventional wisdom is that our malls and playgrounds are veritable buffets for hordes of predators.

But that’s not true. According to Lenore Skenazy of Free Range Kids (citing US Justice Department Statistics), of the 800,000 children reported missing in the US each year, only 115 are “stranger abductions” (most are teenage runaways and 90% of abductees return home within a day).

I’ve been through this kind of freakish security theater myself. When my youngest was five, he wanted very badly to walk to and from the local deli and buy his own lunch. It made him feel very grown-up. And since the deli was all of 500 feet away over low-traffic residential streets, I let him do that a couple of times a week.

The first few times I secretly followed him to make sure he looked both ways when crossing the street and didn’t talk to strangers. After that, I waited on the front porch for him to return, with an ear cocked for any hint of trouble.

Then one day he was picked up by two strangers who scared him into entering their car.  Those strangers — police officers in uniform — drove him home and chewed me out for letting him make the short journey “unsupervised.” They weren’t pleased with my response, but fortunately chose not to escalate the nonsense when I pointed out that it was, indeed, nonsense.

Most of us who are, say, 50 or older, remember childhoods in which we were substantially free to wander within a reasonable distance of home. Our parents gave us rules, of course, but it was understood that roaming one’s community was part of the process of growing up. They didn’t worry about us unless we were late for dinner.

These days, allowing a kid to leave the house alone if he or she isn’t old enough to drive is treated as a bad idea at best and, at worst, as criminal neglect. That kind of fear-mongering is bad for kids, bad for parents, and bad for society. Let’s stop encouraging, even demanding, parental paranoia.

Thomas L. Knapp (Twitter: @thomaslknapp) is director and senior news analyst at the William Lloyd Garrison Center for Libertarian Advocacy Journalism (thegarrisoncenter.org). He lives and works in north central Florida.

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