I recently spent a stimulating day at The Hastings Center in Garrison, N.Y. Since 1969, this pre-eminent bioethics research center has focused on such issues as care and decision making at the end of life, public health priorities and emerging technologies. I hope that many of the scholars I met there will contribute to this blog, beginning with co-founder Daniel Callahan.
Dr. Callahan wrote the essay below at my request, following a provocative conversation about his long-standing — and controversial — support for rationing health care for the elderly. He views rationing as a way of keeping Medicare solvent in an era of more and more old people, more and more advancements in high-tech medical care, and more and more confidence that age is no barrier to successful heart surgery, cancer treatment and the like.
"The biggest change in the last 40 years," Mr. Callahan said to me, "is that there are no limits. There's nothing we can't do for an old person, and there's a lot of pressure to do it. This is considered progress, and it's considered ageism to be skeptical. But we can't go on this way. It's unaffordable. And it's the hardest dilemma in our society because there's no good way to deal with it other than saying 'no."'