How to profit from "death panels"
One supporting argument for age-based limiting of care is that increased spending for seniors deprives younger patients of resources that are rightfully theirs, and thus the ratio of cost to benefit justifies and validates age related rationing of medical services for seniors. Those in opposition stress that age is a weak marker for predicting clinical benefit, and further emphasize that such rationing will lead society to be less and less troubled about this apparent devaluing of elders (Gordon, 2000). Psychologists have been well schooled in the treatment of older patients (American Psychological Association, 2004; Hinrichsen, 2010), but have not been trained to face situations where medical and mental health care are rationed. Through research and clinical experience they might be called upon to help shape the allocation of resources among older patients.
Professionals are placed in a difficult position when asked to screen for problems if services to address them are not readily available. For example the suggestion that primary care physicians routinely screen all their patients for depression must be tempered with the fact that these physicians do not have the time or expertise to comprehensively treat those found to endorse depressive symptoms, and mental health referral systems may be limited in their ability to handle a large influx of depressed patients (Linton, 2004). Psychologists may face a similar ethical quandary when diagnosing dementia or geriatric depression if rationing withholds services from older patients, eliminating their chance to be treated. This trend might offer a challenge or an opportunity for psychologists. Psychologists in settings that care for the elderly might lose jobs or be relocated to working with younger patients, but since psychoactive medication accounts for a good deal of the cost associated with care of older patients, if such medications are restricted or eliminated, there may be an opportunity for psychologists to expand their roles by filling the void with non-pharmacological (and hopefully more cost effective) behavioral interventions.
What about the ethics of fighting back against rationing healthcare to those over a certain age? I just got back my bill from the hospitial for my ICD battery change --the charge was high. As I get older, instead of a battery change, will I just get sent to a psychologist who can help me adjust to dying without treatment? Or perhaps the psychologist will be too busy trying to move to "greener pastures" with younger patients. What an opportunity (or is it a challenge?) for the psychologist.
But at least compassionate psychologists will make a buck! And why is it that when Sarah Palin talks about "death panels", she's an idiot, but when a psychologist does (because isn't that what is implied by restricting care to the elderly?), his ideas are printed up in a journal?
I sometimes wonder if the movie Logan's Run