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Wednesday, May 2, 1990 / University Daily Kansan
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NEW YORK -- Medical ethicist Daniel Callahan was criticized for picking on old people in his 1967 book "The Doctors of Medicine" medical treatment for the elderly.
Book proposes medical limits
This time, he may get criticism from more quarters.
The Associated Press
in the new book, "What Kind of Life? The Limits of Medical Progress," Callahan deals on a broader scale with the same problem: How to rein in the demand for unending health and death, and the unending costs involved.
Callahan argued that U.S. citizens would have to accept limits on medical treatment if there was to be any hope of keeping down costs. This could mean denying expensive, high-tech treatments to those with lower age, as well as to other patients unlikely to benefit from treatment.
There should be a reluctance to use life-extending technology in the care of people who are critically or terminally ill. Callahan wrote.
"A society would . . . be well-jitted in the future to set an age limit on the public provision of expense, health care, health care," according to the book.
In a recent interview, Callahan said, "We will probably have to set limits of one kind or another for all age groups."
The suggestion of an age cut-off is perhaps the most controversial.
"It'll never happen. It shouldn't happen. It's a mistaken idea," said one criminally charged R. Moody of the college Combatry Aging at Hunter College in New York.
Callahan, 59, is co-founder and director of the Hastings Center, a research and educational organiza-
tion that studies ethics in medicine and biology.
Decisions about allocating health care resources now are made on a case-by-case basis, he said. He argued that categorical standards, such as age, should be used to set limits.
One way to accomplish this would be to set age cut-offs for Medicare reimbursement; for example, to deny payment for heart bypass surgery and expensive drug treatments to patients older than a certain age,
Elderly care costs may soar without health-care advances
The Associated Press
WASHINGTON — The costs of caring for the elderly will sour unless there are some new advances in the prevention and treatment of such diseases such as Alzheimer's disease, researchers reported yesterday.
As baby boomers age and medical advances increase their life span, a larger group of people in the United States will be at risk of developing the debilitating diseases that rob the elderly of their independence, the researchers said.
The report was published in this week's Journal of the American Medical Association.
At a briefing about the study,
Sen. Tom Harkin, D-Iowa and
chairman of the Senate Appropriations subcommittee that deals with medical research, said he would introduce legislation to increase federal financing of aging research from $400 million to $1 billion annually.
Applying Census Bureau population projections to inflation-adjusted 1987 Medicare spending figures, the researchers said costs of the program for those 65 and older could triple by 2040, reaching a million. For those 65 and older, these cuts could increase sixfold, they said.
Also, costs for nursing home care, now $3.1 billion for 1.3 million people 65 and older, could rise to $139 billion with as many as 5.9 million elderly people in the United States, most of them more than 85 years old; living in these centers.
Moody argued that an age cut-off was neither desirable nor politically possible.
perhaps 80 or 85.
"When (Callahan) gets into specifics like cutting off care for people beyond age 85, I say no because it isn't going to happen, and it's distracting from the real issues." Moody said.
Limits on treatment for terminal or critically ill patients already exist in the regulations governing Medi-
cal Care. The guidelines set standards and protocols followed by
Callahan said this would not mean abandoning the sick. He advocated increased emphasis on caring medicine rather than curative medicine, on good-quality, long-term care at home and in institutions, and on relieving pain and suffering rather than merely prolonging life.
"What I'm looking for is a kind of tradeoff. We need to improve long-term and home care, and one of the prices we may have to pay is to put some limits on that expensive high-tech curative medicine," he said. "In effect, what we have to do is say, 'Look, folks, you can't have it all.'"
doctors, Moody said. They could be tightened.
"It it could very well be that the medical community would develop a practice, for example, of not giving dialysis to people in the end stage of life," he said. "But that's different from saying it's against the law to do so."
"With a standard practice, someone who wants to deviate from the practice can always do so. As the system gets squeezed for money, doctors will routinely try to discourage families from having so-called heroic treatments. But they might not succeed, and the family might say, 'No, give him one more year of life.'"
That tendency to cling to life, whatever the cost, is part of the problem, Callahan said. Advances in technology have made it harder for patients, families and doctors to accept death.
In looking at the problem of escalating health care costs in the United States, Callahan focused first on the elderly because older people disproportionately are consumers of health care services.
Prisoner suspected in student death
The Associated Press
The discovery of the remains of Joan Webster also renewed questions about the role of the infamous Leonard "The Quahog" Paradiso, a hood doing time for another slaying.
Paradiso never was charged in the Webster case, in which Essex County District Attorney Kevin Burke said he became a suspect immediately after Webster disappeared from Logan International Airport.
BOSTON — Three psychics and a $50,000 reward didn't work. In the end, it was a veterinarian walking her dog who found the bones of a Harvard student who vanished in 1981.
The case was revived after veterinarian Karen Wolf last month stumbled across part of a skull in the woods in Hamilton, a wealthy community 25 miles north of Boston. More bones were found after that.
Joan Webster was last seen at the airport Nov. 28, 1981. The native of Glen Ridge, N.J., and Syracuse University graduate was headed back to the Harvard School of
Confirmation that the remains were Webster's was made Monday. Authorities said that the cause of death was blunt trauma to the head and that Webster was a homicide victim.
"That is some measure of relief." George Webster said of the identification. He sate he and his wife, Terry, had gone to an orphanage in New York.
Design after a Thanksgiving visit with her parents.
The search for Webster turned up her wallet 300 fee, from where 20-year-old Marie Inzulzi's body was dumped in 1979 in Saugus. Saugus is 15 miles from where she lived in Paradiso and Paradiso was convicted of Inzulzi's murder in 1984.
After Webster vanished, her family and friends offered a $50,000 reward. Soon after the disappearance, three psychics came forward, including one who said he was killed by another who did not believe about five rules from where his hopes later were found.
In 1985, attention focused on Paradiso, 45, after a terme conate allegations that the one-time fish merchant accused him of stealing.
Timothy Burke, who was Suffolk County prosecutor at the time, said in an affidavit that Paradiso told an informant that he forced Webster onto his 28-foot cabin on the Malatefemina, with a 'fake' .397-caliber Mammar
According to the account, he hit her on the head with a whiskey bottle and dummed her body in Boston Harbor.
Paradiso, who has defended himself in the media in the past, did not return a phone call yesterday, and a spokesman for the Department of Correction said the Wahole immate refused to speak to reporters.
His convictions include rape and attempted murder of a hitchhiker in 1975, as well as the strangulation of Ianuzz in 1979.
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