U.S. medical care and its delivery are changing and have been for several decades. When was the last time you were sick, called the doctor’s office and actually saw the doctor? Wasn’t your appointment with the “physician’s assistant” or a “nurse practitioner?” Medical practice today often involves patients seeing semi-professionals who have far less training than MDs. I still remember from my childhood when doctors knew their patients well and even made house calls. Today, it’s far more likely that patients are strangers to those who provide their medical care. Is this new paradigm just a consequence of a doctor shortage or is it the deliberate transformation of medicine? And, if medicine in the U.S. is being deliberately transformed, into what is it being transformed and why?
Those seeking change in health care and its delivery make it clear that a primary motivation is to cut costs. Of particular concern is that too many of the elderly and vulnerable cost the system too much in the last few years of life, a waste of resources. The change agents want to limit hospital admissions for the very ill and encourage patients who may not be terminal but have chronic conditions to refuse treatment aimed at curing or controlling their diseases in favor of non-treatment, pain control, and comfort care. But, their targets are not simply the seriously ill. They want everyone at every age, whatever their state of health, to be funneled into the system. Bill Novelli, former CEO of AARP and Board Co-Chair of C-TAC (Coalition to Transform Advance Care), told Congress in 2014:
Our focus is on advanced illness population management not limited by diagnosis, age or mortality risk. It is based on healthcare system integration; interfacing with other care models; and leveraging the healthcare workforce. 1
In other words, everybody from cradle to grave needs to be enrolled in the system as early as possible. Recently, in promoting C-TAC’s book, A Roadmap to Success,Transforming Advanced Illness Care in America, Novelli made this chilling statement, “Transforming healthcare is an ambitious goal but every great social change starts somewhere.” 2 When you consider that the United States health care system has been the envy of the world, one wants to know exactly what “transformation” involves.
C-TAC’s Community Action Project appears to be the vehicle for Novelli’s “healthcare system integration.” It aims to enlist faith-based community organizing groups, pastors, community health resources, hospice organizations, etc. to reach the goal. And C-TAC has a legion of partners supporting their agenda, many with connections to abortion. Allegedly, C-TAC’s program will empower patients and improve end of life care, but many of the leaders in the movement have cost-containment as their primary goal. They want to shift resources from medical treatment to cure patients or control their diseases, to paying for “conversations” about advance planning and focusing on “palliative care.”
Which brings me to a central strategy in the transformation of medicine, language manipulation. Socrates, in his search for knowledge, always insisted on defining terms. Without definitions, one can never be certain all parties are talking about the same thing. But if someone is trying to change the rules of the game without the players realizing it, hiding the meaning of words can be very useful and give him an advantage over the clueless players. Language manipulation is a common tactic of those working for cultural transformation. George Orwell’s book 1984 focused on that point. “Newspeak” (language to support a totalitarian government) was replacing “Oldspeak” (traditional English) so the socialists could more easily control the population. Many terms in Big Brother’s world meant exactly the opposite of their traditional meanings. For example, the Ministry of Love (Miniluv in Newspeak) used violent intimidation, fear, torture, and brainwashing to control, not only behavior, but thought. In addition, the traditional meaning of some words was banned altogether. Orwell described it in his appendix to 1984:
The word free still existed in Newspeak, but could only be used in such statements as "The dog is free from lice" or "This field is free from weeds." It could not be used in its old sense of "politically free" or "intellectually free," since political and intellectual freedom no longer existed even as concepts, and were therefore of necessity nameless. 3
Not only the meanings of words changed, but the language was dumbed down as well. As for Inconvenient facts, they were dropped down “the memory hole,” a simpler process today in the digital age when one can change content with the click of a mouse. Consider the “transformation” of words like “choice” and “gay” to give you an idea of how word manipulation can significantly alter a society.
Orwell’s book is instructive in light of today’s transformation of medicine. It shows how changing language can change behavior, a fact demonstrated throughout history. Verbal engineering always precedes social engineering and those who want to transform health care are manipulating words to make their transforming vision a reality. People need to understand that when they hear common words, they cannot presume the speaker has the traditional meaning in mind. And in fact, words used in medicine today often mean something entirely different from their traditional meanings. Why is this happening? To fool people into accepting a new type of medicine “transformed” from one that recognizes the human dignity of the individual and aims to protect and preserve his life until true death to one based on cost/benefit analysis that weighs the individual’s worth according to his “quality of life” and his benefit to the community.
Many people will presume the traditional definitions are still intact while the transformation takes place. The same thing happened with abortion. In September 1970, three years before Roe v. Wade, the California Journal of Medicine published an editorial titled A New Ethic for Medicine and Society that clearly described the “semantic gymnastics” necessary to change a pro-life culture into one that accepted the killing of children in the womb:
…since the old ethic has not been fully displaced it has been necessary to separate the idea of abortion from the idea of killing, which continues to be socially abhorrent. The result has been a curious avoidance of the scientific fact, which everyone really knows, that human life begins at conception and is continuous whether intra- or extra-uterine until death. The very considerable semantic gymnastics which are required to rationalize abortion as anything but taking a human life would be ludicrous if they were not often put forth under socially impeccable auspices. It is suggested that this schizophrenic sort of subterfuge is necessary because while a new ethic is being accepted the old one has not yet been rejected.4
Within a few years what “everyone really [knew]” about life before birth was cast into oblivion in favor of a lie treating the unborn as a non-person, “just a fetus.” As happened with abortion, medicine is now being transformed from a model that recognizes the inherent dignity of the individual to a utilitarian ethic based on proportionalism. Is the life of the patient and his usefulness to himself and others worth the financial costs of his medical treatment? Note that it is not the patient and his family who will decide. Again, as with the abortion debate, the shift to the new ethic must be hidden until the population is softened up to accept the new paradigm. It’s really the old frog in the pot trick. People won’t accept a “boiling” change, but warm them up to it gradually enough with “semantic gymnastics” and they will be in the middle of the new world of deadly “medical care” without knowing how they got there.
To understand what’s happening, the words being redefined to marginalize vulnerable individuals need to be exposed. So let’s take a look at some of the changes in the language of medicine. I’ll identify traditional definitions as TD and distorted definitions as DD with the new twisted meanings.
Medicine – TD: 1) the science and art of curing; and 2) the medicine one takes (pills, etc)
DD – Medical “Care” : new age concept that substitutes non-curative care: meditation, massage, spiritual counseling, Reiki, etc. for traditional treatment to cure disease (or control it if incurable)
Curing/Healing – TD: 1) the process of making or becoming sound or healthy again; 2) therapeutic
DD – Curing/Healing: having to do more with the spirit and soul than with the body, the ultimate “healing” is death
Changes in these terms are foundational for the transformation of health care. Most people consider the word combinations medicine/medical care and curing/healing to be synonyms. But in the world of transformed medicine they have little in common. Dr. Brad Stuart, speaking at the 2015 Rimini Meeting in August made a stark distinction between healing and curing. “Healing,” he said, has as much to do with the spirit and the soul of the person sitting in front of us…as it does with the body….It’s a Process that’s internal…very deep inside...Healing is coming into the presence of the sacredness of the soul.” On the other hand, “Curing,” he said, “is something that a very intelligent monkey could do. It doesn’t take spiritual insight; it doesn’t take awareness of the soul.”5 Interestingly, however, before making these esoteric statements on healing he described curing as most patients would understand both terms, curing and healing:
Curing is what we doctors are trained to do….We use our brain to assess the patient, evaluate them carefully, use all our knowledge, everything we’ve packed into our memory and training, diagnose correctly, decide on treatment, administer the treatment, and if we are lucky and if we’re skillful the patient recovers. 6
I doubt if most patients consider their doctors “very intelligent monkey[s].” Monkeys don’t have the ability to evaluate, diagnose, and treat. Dr. Stuart’s description of the doctor’s curative role contradicts his earlier insulting statement. His journey into the new age swamp of “healing” where he talks about the “God within us….a deeper I that we can become aware of” transforms medicine into a new age religion. But honestly, if a patient suffers from pneumonia does he want his doctor to cure his disease or communicate with his “deeper I?”
Perhaps in a perfect world where everyone believed we are created “to know, love, and serve God in this world so we can be happy with him in the next,” Stuart’s approach would be fine, and I don’t question his motives; but we don’t live in that world. We live in a culture of death. And the transformation of medicine is being driven by change agents of that culture. One of them, Daniel Callahan, former head of the Hastings Center, a bioethics think tank, said in 1983 that “Denial of nutrition, may, in the long run, become the only effective way to make certain that a large number of biologically tenacious patients actually die.”7 And his organization invests in that outcome. In 1996 he spoke at a leadership conference in Arlington, VA with a three-pronged strategy: to create conversations and natural language about death, to normalize use of narcotics to hasten death, and to get more money for palliative care and counseling groups to encourage patients to refuse care. The Robert Wood Johnson Foundation (RWJF) and George Soros’ Open Society Foundation (OSF), both anti-life organizations, are heavily invested in transforming American health care into managed death care.8 Between them they pumped at least 40 million dollars into transforming health care for the vulnerable into death care. RWJF invested $26 million in 1989 and OSF contributed $15 million in 1994.9 As the pro-abort Emily’s list says, “early money is like yeast” and these foundations have been the sugar daddies of death for decades. And they are just the tip of the iceberg. Between 2011 and 2013, the Peter G. Peterson foundation gave almost a million dollars in grants to C-TAC.10
As in Orwell’s socialist society, definitions have changed in U.S. health care. Traditional medicine used to be about preserving and protecting the lives of the seriously ill and offering curative treatment as long as it benefitted the patient. When treatment no longer helped, early traditional hospice programs offered symptom management, comfort care, and pain control. But at no time would a patient be denied “ordinary” treatment (food, water, antibiotics, etc.) or be administered narcotics beyond those necessary to control pain. Patients would be awake and aware and able to continue to enjoy their families. There would be no “terminal sedation” in order to hasten the patient’s death. Today, however, palliative care has evolved into a new medical specialty (about a decade old) delivered by a multi-disciplinary team that often includes nurses, chaplains, social workers, counselors, and even volunteers. According to guidelines of the palliative care movement certain elements are universal:
- Everyone should have an advance directive to protect himself from unnecessary medical treatment at the end of life.
- Withholding or withdrawing food and water is a natural—and even pleasant—way to die and a perfectly ethical means of controlling the time of death.
- The principle of double effect in the use of pain treatment justifies terminal (palliative) sedation. 11
Palliative care has, in fact, become a “third path” to death, the first being active involuntary euthanasia, the second assisted suicide, and the third palliative care where patients are encouraged to sign advanced directives refusing even ordinary care as the “responsible option.” The palliative care agenda hides behind benevolent terms like “compassion” and “empowering patients and their families” and “choice” (remember that word?). The meaning of “ordinary” care is also being changed to exclude food and water and hasten death.
Some individuals intimately connected to palliative care are exposing the death-dealing strategies being promoted. A priest friend of Rene Gracida, bishop emeritus of Corpus Christi, TX who served on a hospital palliative care team in Texas for a year had this to say about his experience:
In my one year of working daily on an interdisciplinary team…I soon became aware that there was a strong agenda of pushing for a quicker death. …There was always the emphasis on ‘comfort care’ and ‘letting nature take its course.’ By ‘letting nature take its course,’ what was meant was really this: 1) no more treatments to prevent infections; 2) removal of nutrition and hydration; 3) no more treatments that had the goal of finding a cure or were conducive to promoting the patient’s overall health.… We chaplains were required to sit in once every month or two, to listen to the leader of our palliative care team, who was a medical doctor. We chaplains were basically brainwashed into believing that we were being loving when we helped convince family members to choose the third way. We were trained to understand that 90% of medical help is given to a person in their last one or two years of life and, since this is basically wasted money, it is best to convince care givers in families that life is ‘not to be pushed for.’ If a chaplain wishes to keep his or her job, he must cooperate with the palliative team, or, PRETEND to cooperate.12
This priest also said that chaplain friends at other hospitals reported observing the same thing once the palliative team took over. The priest concluded his testimony with practical guidelines for chaplains working on palliative and hospice teams:
1) Do not let the palliative team know that you are pushing for nutrition and hydration, and life giving treatments behind their backs, or they will make sure to keep you OUT of the ministry loop; 2) Talk to caregivers in the family when the palliative team and other medical staff are not around. Inform them of the third way agenda, and encourage them to keep their loved one on nutrition and hydration, along with life saving measures, unless death is imminent (in which case nutrition and hydration can often be…harmful to the body which can no longer process [it].)13
The priest concluded his report with a chilling fact that showed exactly how successful the hospital was at pushing patients out the door. It had “on average, one to seven deaths per 24 hour period.”14
Palliative care receives rave reviews these days even from Catholic sources who see it as an alternative to assisted suicide. They have adopted a dangerous position because modern medicine has been hijacked by the hospice/palliative care movement which has evolved into a strategy to eliminate the vulnerable whose quality of life doesn’t meet the standards of the social engineers. When one considers how many baby boomers will be joining the ranks of the very elderly over the next decade, it’s easy to predict that they will be seen more and more as burdens on both their families and the community. The vulnerable who avoid the first and second paths to hastened death, euthanasia and assisted suicide, are likely to be pushed down the third path where neglect and the morphine drip take them out. It really should be no surprise to anyone that this is happening. After all, our society has approved and promoted killing unborn babies with unlimited potential for half a century. Killing those with little potential left, except in the sight of God and their loved ones, is the natural next frontier for the death peddlers. But in the end the transformation of end of life care is only an interim stop on the way to the total transformation of American medicine.
1 Bill Novelli, Statement to Senate Leaders on Advance Care Delivery, May 21, 2014, online at http://socialenterprise.georgetown.edu/2014/06/bill-novelli-statement-to-senate/
2 PR Newswire, From Status Quo To Action On Advanced Illness Care, September 30, 2015, online at http://www.thestreet.com/story/13307022/1/from-status-quo-to-action-on-advanced-illness-care.html
3 George Orwell, “The Principles of Newspeak” (excerpt), Appendix to 1984, published 1948, online at http://www.newspeakdictionary.com/ns-prin.html
4 Human Life Review, Vol. 1 #1, Winter 1975, Appendix B, pp. 103-104.
5 Dr. Brad Stuart speaking at the Rimini Meeting August 2015, first ten minutes of video online at http://www.pagetwo.us/#!Americans-Speak-at-The-Rimini-Meeting/cmbz/55e6f6340cf29a3653bee38c
7 Dr. Elizabeth Wickham, Ph.D., Today’s ‘palliative care’ Disrespects the Natural Law, Celebrate Life Magazine, Sept-Oct 2012, online at http://www.clmagazine.org/article/index/id/MTA5NjE/
8 RWJF’s Last Acts Campaign outlilnes the “Strategy for Change” to transform the American health care system. See http://web.archive.org/web/20001211191300/ http://www.lastacts.org/la_ala/la_abt_conf-a.htm
9 Extensive information on the history of the transformation of palliative care is available in a detailed timeline at http://lifetree.org/timeline/index.html?id=1
10 Peter G. Peterson Foundation, Grant Report, online at http://pgpf.org/grants/coalition-to-transform-advanced-care
12Priest of Corpus Christi name redacted, Unpublished Testimony of Catholic Priest on Palliative Care Team attested to by Bishop Rene Gracida