Wednesday, October 16, 2013

"free... regardless of pre-existing conditions..."



Commentor troy, who hails from Holland, lays out his ideal healthcare system:

Health care should be free, IMO, in the sense that (1) it is free at the point of use, and (2) regardless of pre-existing conditions and personal wealth or lack thereof.

One should not forget that babies in Holland with spina bifida, which is most certainly a "pre-existing condition", are routinely euthanized.

[A] 1997 study revealed that 45% of Dutch neonatologists and 31% of pediatricians had killed infants. In fact, according to the study, 8% of the infants who died in the Netherlands were actually killed … by doctors.
"Free... regardless of pre-existing conditions". A moral exhortation from a citizen of a country in which 8% of "pre-existing condition" babies who die are killed deliberately by their doctors.

What a precis of liberal moral preening: 'We euthanize children with pre-existing conditions, but it's free.'

And government-regulated healthcare is a reality in many nations in Europe, where euthanasia is, unsurprisingly, increasingly the norm.

What do you think happens to people with preexisting conditions, when the same State that enforces laws on homicide also has to pay exorbitant costs of caring for handicapped people?

Holland is the answer to that question.


36 comments:

  1. The Netherlands' baby-killer enabling act came to mind the other day when Troy was lecturing us on how humane his society is that it will give you a doctor for "free" just like ours will give you a lawyer for "free." Here's what he said:

    "If you can't afford a doctor, die lazy scrounger."

    "Die lazy scrounger" is a pretty good summary of what the medical system and state do to sick children in his country. What the heck good is a doctor who kills his patients?

    If we were to be honest with ourselves, we would admit that NL's baby euthanasia laws are based on cost calculations. Sick children have a lifetime of medical bills in front of them, which the state will have to pay. It's all just so burdensome, so let's just murder the child and pretend he never existed in the first place.

    Joey

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    1. The usual comeback is that killing sick babies is different because they're sick. Um...so? Why can't we just do that to adults? Every time someone is sick, let's just knock them off.

      You also shouldn't use the term euthanasia. Euthanasia is bad enough, but that isn't what this is. Euthanasia implies the consent of the person being killed. No one cares about these children's consent. They care only about the burden of caring for them. So they kill them.

      "Die lazy scrounger" is right.

      TRISH

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    2. ""Die lazy scrounger" is right. "
      The compassion of the 'progressive' mind set. All the clinical evil of their NAZI and Soviet fore-bearers, but none of the fashion sense, honesty, or testicular fortitude.
      They too will have their 'bunker moment'.
      Mark my words.

      Delete
  2. Joey:

    If we were to be honest with ourselves, we would admit that NL's baby euthanasia laws are based on cost calculations. Sick children have a lifetime of medical bills in front of them, which the state will have to pay. It's all just so burdensome, so let's just murder the child and pretend he never existed in the first place.

    Rubbish. The state doesn't make these decisions - parents and doctors do. Read this if you like:


    Infants and newborns for whom such end-of-life decisions might be made can be divided into three categories.1 First, there are infants with no chance of survival. This group consists of infants who will die soon after birth, despite optimal care with the most current methods available locally. These infants have severe underlying disease, such as lung and kidney hypoplasia.

    ...

    Finally, there are infants with a hopeless prognosis who experience what parents and medical experts deem to be unbearable suffering. Although it is difficult to define in the abstract, this group includes patients who are not dependent on intensive medical treatment but for whom a very poor quality of life, associated with sustained suffering, is predicted. For example, a child with the most serious form of spina bifida will have an extremely poor quality of life, even after many operations. This group also includes infants who have survived thanks to intensive care but for whom it becomes clear after intensive treatment has been completed that the quality of life will be very poor and for whom there is no hope of improvement.

    Deciding not to initiate or to withdraw life-prolonging treatment in newborns with no chance of survival is considered good practice for physicians in Europe and is acceptable for physicians in the United States. Most such infants die immediately after treatment has been discontinued.

    Neonatologists in the Netherlands and the majority of neonatologists in Europe are convinced that intensive care treatment is not a goal in itself. Its aim is not only survival of the infant, but also an acceptable quality of life. Forgoing or not initiating life-sustaining treatment in children in the second group is acceptable to these neonatologists if both the medical team and the parents are convinced that treatment is not in the best interest of the child because the outlook is extremely poor.

    Confronted with a patient in the third category, it is vital for the medical team to have as accurate a prognosis as possible and to discuss it with the parents. All possible measures must be taken to alleviate severe pain and discomfort. There are, however, circumstances in which, despite all measures taken, suffering cannot be relieved and no improvement can be expected. When both the parents and the physicians are convinced that there is an extremely poor prognosis, they may concur that death would be more humane than continued life. Under similar conditions, a person in the Netherlands who is older than 16 years of age can ask for euthanasia. Newborns, however, cannot ask for euthanasia, and such a request by parents, acting as the representatives of their child, is invalid under Dutch law. Does this mean that euthanasia in a newborn is always prohibited? We are convinced that life-ending measures can be acceptable in these cases under very strict conditions: the parents must agree fully, on the basis of a thorough explanation of the condition and prognosis; a team of physicians, including at least one who is not directly involved in the care of the patient, must agree; and the condition and prognosis must be very well defined. After the decision has been made and the child has died, an outside legal body should determine whether the decision was justified and all necessary procedures have been followed.


    From here

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    1. Just because the parents agree to killing the child does not mean that the state did not legalize killing children for its own financial reasons. In the case of sick children, the selfish instincts of the parents and the state align.

      By the way, there is no such thing as a baby whose chances of survival are zero. You cannot predict the future and it is not your job to kill off people you think will probably die without your benevolent assistance.

      Nothing in your post contradicts anything Joey said. Now, here's a very simple question. Do you believe that these children should have health care provided for them, regardless of pre-existing condition?

      TRISH

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    2. Just because the parents agree to killing the child does not mean that the state did not legalize killing children for its own financial reasons.

      What evidence can you produce that there is a financial motive at play? Perhaps you should talk to some people who have made such a decision before rushing to a conclusion.


      By the way, there is no such thing as a baby whose chances of survival are zero.

      There is also a non-zero chance the sun will not rise tomorrow morning. Jeebus might decide to stop the earth from rotating - again, according to the Babble.

      Do you believe that these children should have health care provided for them, regardless of pre-existing condition?

      I do,, including medically assisted killing under certain conditions.

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    3. Adm. G Boggs, Glenbeckistan NavyOctober 16, 2013 at 11:09 AM

      Troi: "Jeebus might decide to stop the earth from rotating..."

      So soon? Is he finished with making the oceans recede?

      The Babble is a perfect description. :-)

      Delete
  3. Thank you, Dr. Egnor, for demonstrating what a hypocritical fraud this Troy is.

    The Torch

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  4. Doctor Egnor,

    I have been, several times, queried on your blog as to why I refer to you as 'doctor' and not the other people who hold a PhD who visit this site. The above commentary is an excellent example. I reserve the title fo 'doctor' for either a)formal situations (ie when I am 'captain') or b)when I am talking to a physician who respects the Hippocratic Oath.
    These people you refer to in Holland are murderers with degrees. Should I refer to them as doctors? Of course not. No one should.
    No that leads to a disturbing fact, doesn't it?
    When Holland reports the numbers of physicians to the UN and other respected bodies - they are lying. These people are killers in lab coats. No better than the NAZIs that once occupied Holland. Those Tiger Tanks and jack boots have long gone (except for the case of a certain King?) but, it seems, the ideology they brought with them has metastasised.

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    1. I should also note, having travelled to(and through) Holland several times as a young man, I found the country to be extremely divided on issues such as abortion and immigration. The same is true of the many Dutch born Canadians that I have known over the years. There seems to be a divide along regional lines and the usual urbanite/actual citizen lines.

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    2. I think you smoked too much wacky tobacky during your visits. A very large majority is pro-choice regarding euthanasia. Opponents are mostly conservative Christians or Muslims.

      So an "urbanite" is not an actual citizen, huh?

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    3. "I think you smoked too much wacky tobacky during your visits."
      Actually, I was there on business and so was painfully sober and quite tired. No time or inclination to drink, smoke, or what have you. I did, however, get a little sight seeing done, buy some souvenirs, and visit with some colleagues of mine posted there.

      "A very large majority is pro-choice regarding euthanasia."
      Again, this is not the impression I got. It seemed to me that such sentiments were isolated to certain demographics.

      'Opponents are mostly conservative Christians or Muslims. "
      This may be so, but my own experiences included Jews and very secular people as well. You should also consider: There are more than a few Christians and Muslims in your country.

      "So an "urbanite" is not an actual citizen, huh? "
      Perhaps I should clarify what I mean by urbanite, Troy. English is not your native tongue, and this may be a nuance you are not familiar with. I am using the term technically - ie to describe every soul that resides in an urban environment. Rather only those who exists SOLELY within it.
      So, to answer your question: No. They are merely technically citizens of the broader nation, but their reality consists of the microcosm that is (the centre of) their world.

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    4. **I am NOT using the term technically - ie to describe every soul that resides in an urban environment. **

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    5. No, Troy - representative polls among Dutch adults, including superstitious idiots like yourself, show consistently >80% approval of euthanasia. Many Americans are in favor of it too, it's even legal in some enlightened states, and it happens a lot too, but more hush hush because many religious idiots prefer to think an imaginary person should decide the time and place of death.

      Delete
  5. troy <3's infanticide. not just inside the womb either but outside too.

    naidoo

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  6. Adm. G Boggs, Glenbeckistan NavyOctober 16, 2013 at 8:01 AM

    Actually, Troy's provocative comment was silly and stupid (as they invariably are).

    Troi notwithstanding, the reason that the Dutch state permits the murder of spina bifida infants is shown here. The graph shows a proposed level of health care investment by the state for individuals during different stages of the life cycle.

    That graph was developed by Ezekiel Emanuel, a "bioethicist" and brother of Rahm Emanuel, former White House Chief of Staff in the Jeebus Administration. The basic thinking behind it is identical to that of a rancher or large poultry producer.

    Egnor: "What do you think happens to people with preexisting conditions, when the same State that enforces laws on homicide also has to pay exorbitant costs of caring for handicapped people?"

    This happens: cull the malformed infants/calves/chicks before they incur excessive medical costs, and spend less on their care as the monetary Return on Investment begins to decline.

    There's nothing shocking about it, really. It's simply an approach that makes the most sense from a livestock management perspective; and that's the only perspective logically possible for a secular materialist such as Troi.

    As Egnor notes, Troi enjoys preening on a moral stage, but the moral veneer wears through pretty quickly.

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    1. "There's nothing shocking about it, really. It's simply an approach that makes the most sense from a livestock management perspective; and that's the only perspective logically possible for a secular materialist such as Troi."
      Excellent point, Adm. Treating people like animals under the law is to be expected from people who see other humans as nothing more than animals and see the law as merely a subjective vehicle for livestock control.
      Troy is simply being consistent with his belief system.

      Delete
  7. Adm. G Boggs, Glenbeckistan NavyOctober 16, 2013 at 8:18 AM

    More on the Groningen Protocol (see Troi's NEJM link, above):

    How does the Groningen protocol attempt to justify euthanasia for infants? In the NEJM paper, the authors specify five criteria that must be met in order for euthanasia to proceed: (1) the infant must have a certain diagnosis and prognosis, (2) he or she must have hopeless and unbearable suffering, (3) criteria 1 and 2 must be confirmed by at least one independent doctor, (4) both parents must give informed consent, and (5) the procedure must be carried out in accordance with the accepted medical standard. By proposing these criteria, the authors imply that euthanasia of infants that meet these conditions is ethically permissible...

    Ethical analysis of criteria number 2 and number 4 is sufficient to demonstrate the reasons this practice should be stopped. With regard to the second criterion: infants are clearly capable of both pain and suffering, but they are not able to verbalise or communicate about that suffering. Although pain and possibly even suffering can be accurately diagnosed, “unbearable” suffering is an unknowable entity. There is a serious metaphysical problem with measuring what constitutes “unbearable” for anyone who cannot communicate. In fact, adults and older children who are able to communicate might deem their own suffering as unbearable in the morning but tolerable later the same day. The leap of faith required to assess this level of suffering in an infant with any certainty suggests a mirage of clinical accuracy that borders on hubris... Because the second criterion is predicated on the ability to measure something which is immeasurable, it is deeply flawed.

    The fourth criterion is even more objectionable than the second. Because parental consent is an incoherent concept, the Groningen protocol has no firm philosophical basis. The American Academy of Pediatrics and others have pointed out that parental permission (authorising action on another) is a more accurate term than consent (authorising action on oneself) for medical decisions parents make on behalf of their children. The Belmont report describes the ethical principle of respect for persons as including two components: deference to patients' autonomy and protection of vulnerable patients who cannot exercise their autonomy. For infants, the former component is irrelevant but the latter concept is of paramount importance.

    --- E Kodish, The Lancet, v371

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  8. I have said for years that societal acceptance of aborting mentally and physically handicapped children before birth would lead like night into day to killing mentally and physically handicapped children after birth.

    Another reason often cited for abortion is that the mother does not have the means to raise the child. That's the next frontier in killing. Just as we blew past the arbitrary demarcation line of birth when it comes to killing our handicapped children, so too will we blow past the same arbitrary demarcation line when it comes to killing poor children.

    Think about it. If a mother cannot afford to raise her child, who are you to judge her if she feels like tossing him or her into a river? She didn't have the means to pay for the child's upbringing. It's her choice and none of your business.

    --Francisca S.

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  9. Holland and the Netherlands are not synonymous. Holland is a part of the Netherlands, like England is a part of Britain.

    http://en.wikipedia.org/wiki/Holland

    JQ

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    1. Very true, JQ.
      However, my own travels were in Holland (Hague & Amsterdam).

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    2. *and it is the seat of both the elected government and the crown.

      Delete
    3. Thought you might be interested in this........

      'Doctors administered lethal injection to blind Dutch woman… after loss of sight passed 'unbearable suffering' test under country's euthanasia laws

      The woman was said to be 'suffering unbearably' because of blindness
      It is first time blindness has been cited as a reason for euthanasia in Holland
      She was 'obsessed with cleanliness' and hated not seeing stains on clothes
      Holland became first country in the world to legalise euthanasia in 2002
      Now nearly ONE in SEVEN Dutch people die at the hands of doctors'

      By Simon Caldwell

      PUBLISHED: 13:45, 7 October 2013 | UPDATED: 01:55, 8 October 2013

      Read more: http://www.dailymail.co.uk/news/article-2448611/Blind-Dutch-woman-euthanised-loss-sight.html#ixzz2huk4vYSi
      Follow us: @MailOnline on Twitter | DailyMail on Facebook

      Above you mentioned the Nazis.
      If 1/8 children who die and 1/7 adults are killed by 'Doctors'; then there is no way that Nazis were ever as dangerous as 'Doctors' in Holland.

      ps the obvious and glaring social cultural 'split' you noticed when in Holland goes back to the Reformation (at least).
      During the last war some Dutch joined the SS (wiped out easily, you can see footage of them with Hein. Himm. on Youtube).
      Others (urbanites) fought bravely with German soldiers in attempts to save Jews from being rounded up. Many were killed, some in Hospital later when (Army Officers murdered them alongside a few nurses whe protested).
      The Dutch State had formally 'registered' all it's citizens & that included Jewish citizens before occupation. Consequently very few Dutch Jews survived.

      John Richardson



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    4. John,

      Thanks for the input and the link.
      As for the divide, I am not so sure it was entirely a remnant of the reformation, but I would certainly not brush off the connection. To me it seemed to be more about life experience and style of education.
      As for your note on the 'urbanite' resistance, I again refer to the above clarification. I used the word in a nuanced, spirited way and after realized how colloquial my expression had been. There was no way Troy would get it (even if he was intelligent) and so I explained.
      I, myself, was born in and then raised in three very big cities.
      I have been an urban dweller most of my life. A 'city-kid', if you like. My escape was more recent.
      The creatures of which I speak would not lift a finger to help some minority in distress unless there was some social or financial benefit. The only things they are interested in elevating are their social standing, bank accounts, and the occasional latte.
      There are still plenty of good folks in the city. I did not mean to state otherwise, hence the clarification to Troy.

      Delete
  10. I was actually responding to the main post, not to your comment. Doc Egnor used the word Holland when he should have said the Netherlands.

    JQ

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    1. I suspect most Dutch would say "I'm from Holland" when asked where they hail from, although Dutch from the 'periphery' ("de boeren") are less likely to do so because of regional pride issues (which absolutely pales in comparison to Scottish loathing of everything English; I lived in Scotland for a while and remember the festivities [i.e. drunken cheering] after England was knocked out by Brazil during world cup football). Me, I usually say "Holland" although I'm a hick from the sticks.

      By the way, if Dutch doctors are on such a murdering rampage, how come we outlive Merkins by several years?

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    2. "By the way, if Dutch doctors are on such a murdering rampage, how come we outlive Merkins by several years?"

      Obesity, violent crime, and car accidents.

      The Torch

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    3. Obesity, violent crime, and car accidents.

      Does that also account for higher infant mortality in the US? Fat babies dying from coronaries while escaping by car from violent bank heists? I dunno, but it seems unlikely.



      Delete
    4. Adm. G Boggs, Glenbeckistan NavyOctober 16, 2013 at 7:20 PM

      Longevity is a poor proxy for an indicator of health care system quality, confounded by cultural, ethnic, and racial subpopulations.

      A better indicator of health care is cancer survival rates, since it measures the efficacy of actual medical intervention. Using this metric shows that the US is far better than Europe:

      For all cancers, Europe had a much lower survival than the US. Survival for prostate cancer in the US is 91.9% compared to 57.1% in Europe - a 34% difference. The difference for breast cancer survival, however, is 10%. In Europe, the western countries generally had higher cancer survival rates: France led survival for rectum and colon cancers, Sweden led for breast cancer (82%), and Austria led for prostate cancer...

      "Most of the wide global range in survival is probably attributable to differences in access to diagnostic and treatment services."

      --- Coleman, et. al, The Lancet Oncology

      One of the differences in infant mortality is simply a difference in what counts as a live birth:

      European countries have adopted a variety of different practices for stillbirth and live birth registration, and this limits the comparative value of perinatal mortality as an index of health care.
      --- Woods, Bulletin of the World Health Organization

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    5. Georgie,

      Are you quoting from the article in 'Lancet' from 2008. I can't find your quote (it's a very long article though, and I might have missed it).

      It deals with cancer diagnoses 1990 to 1994, with follow up till 1999, so it's old and confined to just 5 year survival.

      It also notes that American blacks have significantly worse survival, probably due to suboptimal treatment as a result of having inadequate medical insurance.

      Delete
    6. hey troy, you seem awfully concerned with babies dying for someone who's actually defending a policy of killing children.

      naidoo

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    7. but babies aside, and i know you don't count them as human beings, i think you know that the explanation provided by the torch is pretty accurate. obesity, violent crime, and car accidents will have that affect.

      naidoo

      Delete
  11. Michael,

    What's the point of your thread? Are you claiming that Troy doesn't have the right to lecture Americans on the finance of healthcare because he comes from a country with legal euthanasia? Or because having a system where there is a single payer encourages euthanasia as a means of reducing costs?

    If the second (and my reading indicates that that's your claim), then Australia disproves you. Australia effectively has a single payer, Medicare, state-run, for almost 40 years, which is extremely popular.

    And euthanasia isn't legal, despite a campaign by terminally ill mentally competent patients for it to be made legal. And neonates aren't euthanised as a matter of course. I remember a recent case in which a neonate with very long segment Hirschsprung's disease (in which varying lengths of the bowel fail to develop neural control and fail to function) was maintained for 8 very long years with total parenteral nutrition (a very expensive and onerous procedure) and eventually developed liver failure (a common complication of total parenteral nutrition). The state then funded a combined liver, pancreas and bowel transplant.

    It would have been considerably cheaper to have allowed the neonate to have died soon after birth, by not feeding him. But it wasn't done.

    But anyway. Governments don't pay for health care. Their taxpayers do. Similarly, health insurance companies don't pay for health care. Their policy holders do.

    Insurance companies have to make a profit, or they'll go out of business. Governments don't have to make a profit. They can go into deficit or increase tax rates. There's no financial incentive for governments to legislate for euthanasia because they're not paying the costs of health care.

    The criticism of America's health care is because it's expensive (16% of GDP) and not very good. Australia spends 9% of GDP on health care and has better outcomes.

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  12. Meanwhile, Congress votes to reopen the government and raise the debt ceiling. The GOP learns a valuable lesson: the stove is indeed hot.

    Hoo

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  13. The horror of social darwinism

    best wishes

    chris uk

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  14. some dishonest person: "By the way, if Dutch doctors are on such a murdering rampage, how come we outlive Merkins by several years?"

    The Torch: "Obesity, violent crime, and car accidents."

    Furthermore, as been pointed out already, the US doesn't fudge on the count of live births as the Nederlands, and most European states do. It doesn't take all that many deaths at age 0 to bring a population's average-age-at-death dramatically down.

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