So let's say it's like this:
I am lying in a hospital bed. I'm 65. I have had cancer once and, because of a genetic condition, will probably have it again. I have a body that my late horseman-father would have described as "rode hard and put away wet." My arteries are turning to calcified mush. I have a blocked carotid artery and two blocked femoral arteries. I am a diabetic. I just had surgery to clear one blocked artery and replace a valve in my heart and have a recently discovered small aortic aneurysm. All in all, I have had a great life and gotten to see and do a lot of things that friends, loved ones and guys I knew in Vietnam never got a chance to experience.
In the next room, let's say, there is a 32-year-old father of three whose heart is going bad because of a bacterial infection. He is otherwise in good health, is a scoutmaster, volunteers with community organization and will die if he doesn't get the heart.
Or maybe it's a 25-year-old single mother busting her butt at a menial job trying to keep her two kids on the straight and narrow and wondering if she will see either of them graduate, marry or give birth to their own children.
A heart is available.
All other things (rejection possibilities and the like) being equal, who gets the heart?
I don't envy the person who has to make that decision between the other two, but I know that I shouldn't be the one to get the transplant.
Ask me when I am gasping for breath and in pain and I will probably give you a different answer.
That's why decisions about how to approach that question are best made by disinterested (not uninterested) people considering all of the factors and criteria that go into the decision.
And it goes on all the time, as it should.
Death committees as currently screamed about at town hall meetings by people who let talk radio morons do their thinking for them, do not exist in any of the proposals for health care reform. (Not that that fact will shut anyone up.)
But they have existed in this country in different forms for years, most notably when the invention of the Teflon shunt helped move kidney dialysis from the realm of the experimental to being a usable treatment modality.
The problem was that there weren't nearly enough machines to take care of all of the patients, and many hospitals had committees made up of physicians, clergymen and other community members to decide who got dialysis and who died.
These were (ahem) private (private) death committees.
Things didn't really get better until 1972 when Congress decided to fund dialysis through Medicare (a, ahem, government program).
Today, some 345,000 Americans, including a dear friend of mine, are being kept alive by dialysis.
At the risk of hammering home a point too hard, it wasn't medical corporations or insurance companies that saved all of those lives, it was government realizing that the right to life, liberty and the pursuit of happiness works better for those who are actually alive.
And trying to make an issue of end-of-life counseling is obviously being ballyhooed by those who have never had to make that decision.
I have, twice.
I had to tell doctors to stop resuscitating my last wife because there was nothing that was going to save her life and they really couldn't stop until I said to.
I had to go through the same thing with my stepfather after a doctor at an Ocala hospital ignored a Do Not Resuscitate order and I had to fire him and hire another physician to comply with my stepfather's wishes and with approved medical practice.
I could have used some advice from someone other than a couple of with-it ICU nurses who risked their jobs to tell me what nobody else would.
Despite the fact that I recently benefited greatly from the health care system functioning as is, I know dozens of other people who would not have because they don't have insurance, and assistance programs won't kick in until they are either declared disabled or admitted (late in the process of their illness) through an emergency room.
Unlike many veterans, I don't have a problem with the VA, which has treated me well and quickly whenever I have gone in. I am also quite happy with Medicare and see a lot of people who benefit regularly from Medicaid.
There is nothing wrong with a public option, and if medical corporations, pharmaceutical companies and insurance companies are suddenly thinking of ways to head off reform at the pass by improving their services ... why didn't they think of that 20 years ago?
Ignore the scare tactics about pulling the plug on grandma and rationing of care. Find someone (hint, don't look in most congressional offices or on your radio dial) who actually knows what is going on.
Stop screaming and listen.