Obama health-care policy advisor Ezekiel Emanuel announced a new "Complete Lives System" for selecting which sections of the population should be killed, in his article "Principles for Allocation of Scarce Medical Interventions."
Published Jan. 31, 2009 in the British medical journal Lancet, Emanuel's euthansia-selection article appeared 11 days after President Obama's inauguration. Then on March 19, Emanuel was appointed to the Federal Coordinating Council on Comparative Effectiveness Research, to begin the design of a Federal system for withdrawing care from those chosen for death.
Though written in bloodless academic language, Emanuel's discourse most closely resembles one of Adolf Hitler's rambling pronouncements as know-it-all Fuehrer.
Emanuel sums up who is to be treated, and who is to die:
"When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated." This may be justified by public opinion, since "broad consensus favours adolescents over very young infants, and young adults over very elderly people."
Emanuel decrees that we must not kill only the elderly, but also infants.
"Strict youngest-first allocation directs scarce resources predominantly to infants. This approach seems incorrect. The death of a 20-year-old woman is intuitively worse than that of a 2-month-old girl, even though the baby has had less life. The 20-year-old has a much more developed personality than the infant, and has drawn upon the investment of others to begin as-yet-unfulfilled projects.... Adolescents have received substantial substantial education and parental care, investments that will be wasted without a complete life. Infants, by contrast, have not yet received these investments.... It is terrible when an infant dies, but worse, most people think, when a three-year-old child dies, and worse still when an adolescent does."
He proclaims his new "Complete Lives System" to be an advance over previous death-selection systems such as Quality-Adjusted Life Years and Disability-Adjusted Life Years.
He criticizes the random ("lottery") selection of those to be saved, as based on the supposedly unscientific notion that "each person's desire to stay alive should be regarded as of the same importance and deserving the same respect as that of anyone else." He claims that this attitude shows "blindness to many seemingly relevant factors. Random decisions between someone who can gain 40 years and someone who can gain only 4 months, or someone who has lived only 20 years, are inappropriate."
Emanuel the "reformer" assures us that unlike other death-selection systems, "the complete lives system is least vulnerable to corruption. Age can be established quickly and accurately from identity documents."
Near the end of his Lancet article, Emanuel responds directly to an old article ("Rationing Health Care: The Case Against" by John Grimley Evans, British Medical Journal, March 15, 1997) that attacked the Nazi character of the policy Emanuel proposes.
Evans had written, "Surveys in Britain show that older people are widely seen as of lower social worth than younger... [S]ome researchers suggest that public attitudes displayed by such surveys are a valid basis for rationing in the health services.... [W]ould researchers suggest that racial prejudice revealed by their questionaires should be a basis for health service rationing?... We should not create, on the basis of age or any other characteristic over which individuals have no control, classes of Untermenschen whose lives and well being are deemed not worth spending money on."
Ezekiel Emanuel, chief health-care policy adviser to President Obama, replies to Evans, "Ultimately, the complete lives system does not create 'classes of Untermenschen whose lives and well being are deemed not worth spending money on,' but rather empowers us to decide fairly whom to save when genuine scarcity makes saving everyone impossible."