Health Policy, Politics, and Professional Ethics


Read the section titled “Reflective Practice: Pants on Fire” from chapter “Health Policy, Politics, and Professional Ethics” and address the questions below:

Reflective Practice: Pants on Fire

Sarah Palin is famous for urging her supporters to oppose Democratic plans for health care using the scare tactic of death panels. She said the Democrats plan to reduce health care costs by simply refusing to pay for care:

And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s death panel so his bureaucrats can decide, based on a subjective judgment of their level of productivity in society, whether they are worthy of health care. Such a system is downright evil.

In fact there was no panel in any version of the health care bills in Congress that judges a person’s level of productivity in society to determine whether they are worthy of health care.

The truth is that the proposed health bill would have allowed Medicare, for the first time, to pay for optional doctors’ appointments for patients to discuss living wills and other end-of-life issues with their physicians. PolitiFact awarded Palin with the 2009 Lie of the Year for the death panel claim, but the political impact of her statement is hard to overstate. In 2011, the Obama administration even deleted all references to end-of-life planning in a new Medicare regulation when opponents interpreted the move as a back-door effort to allow such planning. So even, in the regulations Palin achieved her goal (Holan, 2009).

  • How do you judge Palin’s quote? [“And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s death panel so his bureaucrats can decide, based on a subjective judgment of their level of productivity in society, whether they are worthy of health care. Such a system is downright evil.] Effective strategy to oppose Democrats’ plans for health care reform or unethical scaremongering?
  • Reflect on what informs your judgment: commitment to advance care planning, analysis of facts, and/or political party loyalties?
  • Is it right for nurses to endorse health reform legislation even if the legislation is not perfect? Does this apply to the recently failed American Health Care Act?