It's a sad day for health care in America now that Republican senators have refused to confirm Dr. Donald Berwick, who has been serving in a recess appointment as Administrator of the Centers for Medicare and Medicaid Services .

Some naysayers in Congress are attacking the Prevention Fund proposed in Obama's Affordable Care Act, labeling it a 'slush fund.' They are completely missing the point.

Are there circumstances in which patient autonomy, as expressed through surrogates, should be overruled in the name of resource allocation and/or sound medical practice?