A key issue with both life issues that have flared up in the healthcare debate—“death panels” and funding for abortion—is coercion. If healthcare reform requires doctors to consult with their elderly or other patients about end of life healthcare options, and facilitates funding for abortion, will patients be pressured to forego costly life preserving interventions or to have abortions?
I think the danger is greater with abortion. Although pro choice advocates often scorn the claim that doctors pressure women to abort, I’m firmly convinced they do. I’ve seen it happen, even in my sheltered little world. It’s easy to see why. If tests show a high risk of problems, a doctor can’t help but fear she’ll be blamed, and possibly face a big malpractice suit. If the doctor is pro-choice, there’s a powerful incentive to push for abortion. Some, perhaps many, do. Any healthcare bill that increases funding for abortion, whether directly or indirectly, will make it easier for doctors to prod more people to have abortions.
With elderly patients, on the other hand, doctors do not have the same perverse incentives. Regardless of which treatment a doctor counsels, she is not likely to be sued by the patient’s family if the patient dies. So long as the doctor with whom the patient consults does not have a financial incentive to steer patients away from life preserving interventions, the risk of coercion is relatively low.
The death panels have made for dramatic talking points, but I think the more frightening issue is the risk that the coming reforms will mean more money and more pressure for abortion.