July 29, 2009
By Jeffrey Weiss
Most of the arguments we're hearing about health care reform involve big numbers: Millions of people now uninsured, billions of dollars to be spent or saved.
And that's probably the right place to start the discussion – in the middle of the bell curve where most people live. But what about the relatively few people on the rest of the bell curve? What about people who live only because their doctors took a chance that defied the statistics? How do we include them in the system?
These are personal questions for me. My Dad is now 91. . .
Dr. Tom Mayo is the director of Maguire Center for Ethics and Public Responsibility at Southern Methodist University in Dallas. He also teaches at the SMU law school and the UT Southwestern Medical School. He co-chairs the institutional ethics committees at Parkland Memorial Hospital and Children's Medical Center of Dallas.
The question of how to handle the statistical outliers will surely ignite a political firestorm as the health care reform debate moves forward, he said.
"I think we have to start in a position of humility," he said. "No system is going to capture all the nuances that you or I or your dad or some policymaker might want to capture."
Where should we draw the lines?
"Human bodies don't follow algorithms with anything like scientific precision. We can write algorithms for the fat part of the bell curve, but we also need to practice medicine," he said. . .
"At some point if you are trying to give God an opportunity to work a miracle, how much of a chance does God deserve? We often have those discussions when a patient's family has a very different idea for God's plan for the patient than the doctors have for God's plan for the patient."
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