Apparently, some medical societies are buying into the distrust sowing meme that doctors should give better care to some patients than to others. Why? Duty to society. From the New York Times story:
The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent.
ah but the Hippocratic oath is about the ethical duties to a patient.
By making doctors obey society, they twist the profession into one that obeys the policies of the government.
Leo Alexander has the classical article on this in the NEJM in 1948(Before it became the favorite journal of the culture of death). I don't know if the article is on line because the webpage won't link.
This article has no abstract; the first 100 words appear below.
SCIENCE under dictatorship becomes subordinated to the guiding philosophy of the dictatorship. Irrespective of other ideologic trappings, the guiding philosophic principle of recent dictatorships, including that of the Nazis, has been Hegelian in that what has been considered "rational utility" and corresponding doctrine and planning has replaced moral, ethical and religious values. Nazi propaganda was highly effective in perverting public opinion and public conscience, in a remarkably short time. In the medical profession this expressed itself in a rapid decline in standards of professional ethics. Medical science in Nazi Germany collaborated with this Hegelian trend particularly in the following enterprises:
Try this one LINK
Medical science under a dictatorship.
a lot of the "futile care" part is about not treating the brain damaged or senile. But this isn't about expensive treatment, but has migrated into feeding: So you put in a feeding tube because the nursing home nurses are too busy to properly feed someone (or too cheap to do it) and then you pull the feeding tube as "unwanted medical care".
Which is why John Paul II allowed a feeding tube for his Parkinsonian crisis: (where if he hadn't died of infection he might have recovered). To show that you don't just throw away people.
And if you think this idea is limited to those in vegetative state, you are mistaken.
We had a patient with frontal lobe syndrome and quadraplegia , and asked a neurologist the best way to treat her symptoms of excess emotional outbursts that upset the ward (if she saw you, she'd scream and cry in happiness, sounding like she was in pain. It's called paradoxical emotional reaction).
The neurologist spent the hour not examining the patient but talking to the family to try to persuade them to pull her feeding tube (which was in for staff convenience) so she could die. The Native American family was quiet, not because they agreed but because they were angry. On leaving, one cousin, who had enough western education to be disrespectful, said: That is the difference between you white people and we Indians: We respect our elderly.