This decision of the task force, while based on science, was in the final analysis a judgment call: the collective wisdom of 16 people presented with a range of reasonable options and no doubt influenced by their view of what's best for society as a whole. The call would easily be otherwise among 16 other experts—equally well schooled and presented with the exact same science—whose goal is primarily to maximize the number of lives saved. Unless there is a special act of Congress, as we saw in the Senate last week when Sen. Barbara Mikulski's health reform amendment was passed to ensure women reimbursement for mammograms prescribed by their doctors, choosing one set of guidelines over the other will mean less or no reimbursement for the guidelines not chosen—even if one is current practice.
These types of decisions, and the many others that lie ahead, demand that the full story be told, and explicitly: the science, the choices, the judgments and opinions, and, why not, the emotional dimension that must always be considered when human life is at stake. When there are legitimate differences of opinion on widespread medical practices and more than one scientifically based approach to care, it would seem unfair for the government to effectively begin rationing treatment by favoring just one.
[Read more about how health reform could mean the government dictating care.]