Buzz words or principles?:

...But late a broad range of principles that should declined to testify for fear of having his then, we have to ask, what contribution motivate any new health-care system, and views distorted and manipulated by the po- did the ethics group make...

...sold in terms of certain ethical standards, the relationship between ethics and pol- But as two participants admitted, they and told Ira Magaziner, head of the task itics...

...were not the kinds of issues they dis- who led the "values framework" subgroup Three years later, watching the nation- cussed...

...One of the most polit- likely be gleaned from the values and to deal explicitly with end-of-life decision cally difficult-medical rationing-wasn't principles articulated by the ethics task making-a major ethical issue...

...feasibility of marrying ethics and politics But remembering the words of my reremains an open question...

...Thus, ETHICS & HEALTH-CARE REFORM consultants working on the basic benefits package, the structure of the purchasing cooperatives, and other central components n June 1990, when I was lining up aspects of the plan said they had little or of the system, were not waiting for the the witness list for a Senate no exposure at all to the "ethics people...

...Of the four hun- luctant witness of three years ago, I worry dred or so members of the President's Task that participation of the ethicists gives the Force on National Health Reform, a small appearance that the plan has an ethical number were engaged in the discussion of stamp of approval, though none of the hard ethical matters...

...school and convinced of the political rel- fits they provide...

...ethics group to conclude their deliberaFinance Committee hearing on In one sense, that isolation might have been tions...

...A trial balloon raised equately the nuances and complexities of even discussing whether some forms of by the administration in August used many the issue...

...The preamble to the bill will be loadrespected ethicist expressed skepticism Hillary Rodham Clinton, the administra- ed with words such as security, choice, about the capacity of a political forum, such tion needs to prove its credibility in con- quality, access, and efficiency that signal as a congressional hearing, to capture ad- taining overall health-care costs before valued principles...

...were under no illusions that their work was OF SEVERAL MINDS Liz Leibold McCloskey in any way intended to form the ethical foundation of the new system or that policy choices to be made turned on ethical considerations...

...Although the ethics group ethical questions has been addressed...

...And although Mrs...

...Arthur Caplan, economic factors...

...Thus, the parameters of fessional ethicists have missed the opthe new health-care system were set be- l portunity-a rare one-of contributing to fore the ethics group ever met, and par- "This is a political problem-let's the public debate without being used by ticipants in groups constructing basic not drag ethics into it...

...E 10: 24 September 1993 Commonweal...

...The bill, which became law evance did its deliberations have in the for- the Clintons frame a philosophical apthat fall and which required medical fa- mation of the Clinton health-care policy...

...But it seems to me that the proform health care...

...Even the volatile issue of includ- of the ethics cluster, says he would be al health-care debate, I think this bioethi- ing abortion in the basic benefits package happy to see the health-care reform plan cist may have made a salient point about was not on the group's agenda...

...be used as justification for the plan...

...the Patient Self-Determination positive because each group was free to The ethics group did, however, articuAct, a prominent medical ethicist function without outside pressures...

...proach to the complex issue of health-care cilities to distribute information about liv- There is no question that in the realm reform...

...the process...

...Caplan believes that these As the Clinton administration begins to standards would serve to hold the plan acunveil its plan for our ailing system, the countable...

...Only two years out of divinity medical care are worth the limited bene- of these buzz words...

...Yet this even touched...

...Of did not convene until many of the other course, these are not easy questions nor "clusters" and "subgroups" were well un- is the relationship between ethical delibderway, one of its tasks was to articulate erations and practical policy outcomes the principles underlying the effort to re- clear-cut...

...When it comes time to sell the ing wills and durable powers of attorney, of health-care reform, critical ethical choic- health-care program, the rhetoric will most was the first piece of federal legislation es must be made...

...Nonetheless, the ethics participants evance of ethics, I argued with him that Clinton's aide was under the impression hope that as the program is put forward, ethicists have a responsibility to engage that the ethics task force made thoughtful their contribution will not only be part of in the public dialogue about health-care contributions and recommendations with a public relations campaign, but will also issues to ensure that the human and ethi- respect to end-of-life decision making, par- be used as a standard by which to meascal dimensions be addressed along with ticipants in the ethics task force said these ure the ultimate product...

...In the view of an aide to force...

...force, as much...

...And what rel- these contributions have apparently helped litical process...

...Rather, their work would BUZZ WORDS OR PRINCIPLES...