Amid the rising costs of health care, it is tempting to think that for the good of the “team” some individuals should be denied care. This is apparently the logic of Dr. Ezekiel Emanuel, health-policy adviser to the Office of Management and Budget. In a recent editorial of the Wall Street Journal (August 26, 2009), it is reported that Emanuel calls improving the current system mere “lipstick;” instead, what is required is a wholesale reevaluation of the medical mindset itself, including a medical doctor’s Hippocratic Oath to “use my power to help the sick to the best of my ability and judgment.” According to Emanuel, such thinking myopically focuses on the individual to the jeopardy of society. In other words, some individuals should “take one for the team.”
In one sense, this proposal is logical, perhaps even heroic. If there are limited resources preventing everyone from being served, then some individuals should step aside so that others in greater need can be served. Much of Christianity is based on this principle of self-sacrifice, epitomized in the voluntary death of Jesus Himself for the sin of the world. Two things, however, bother me about Dr. Emanuel’s reasoning. First, is it really true that there are limited resources? Not only can God multiply our assets (if only we would turn to Him in repentance, rather than ban Him from mention in our public square), but even on a human level, there is so much waste due to litigation threats and the lack of accountability in pricing due to the impersonal nature of the insurance industry. Can nothing be done here? Second, on a more philosophical level, who has the right to decide who should get care? It is one thing to die voluntarily for the good of society, but quite another thing to be denied care, even when you as an individual could pay for it. Does any governing board really know that a particular life is worth more to society dead than alive? Can we humans foresee all the ramifications?
On September 2, 1944, several American flyboys careened towards the island of Chichi Jima in order to take out some Japanese radio stations. The third plane took a hit, yet managed to drop the bombs as commanded, before the crew “hit the silk” to escape the burning plane. Just before the plane exploded, the twenty-year-old pilot bailed, and spent over three hours in a yellow raft, while American planes fired 1,460 rounds of machine gun bullets at Japanese boats to keep them at bay, allowing the American submarine USS Finback to eventually pick up the pilot. That pilot’s name was George H. W. Bush, the forty-first president of the United States. Years later, a Japanese soldier told the president, “Do you know what the Japanese soldier next to me said when we saw the submarine that rescued you? He said, ‘American sure take good care of their pilots!’ Sending a sub for one pilot was something Japan would never have done.” To the Japanese, the wounded were an impediment. For the good of the “team,” the wounded typically either killed themselves or were killed (see James Bradley, Flyboys, pp. 142, 192-97, 334).
Sadly, America herself is now beginning to reason like imperial Japan. God’s law commends the care of the orphan and widow, but we Americans are beginning to estimate the value of a deformed infant and a demented lady strictly in terms of the good of society. Do we know such things? Do we know what that infant will become? Do we know what profound effect that older lady may be having on those around her, even when she herself can no longer think? Am I God, knowing the end from the beginning? If not, why do I assume His place, making decisions about who should live and who should not?
Remember, it was wicked Caiaphas that justified the destruction of Jesus by saying, “It is expedient for us, that one man should die for the people, and that the whole nation perish not” (John 11:50). We are beginning to see the return of Caiaphas today—men who sit in God’s place and make decisions about ultimate good, as if they really did know. Beware of such gods in our midst! Ironically, Dr. Emanuel’s last name literally means, “God-with-us.”