At a dinner to celebrate Bill Clinton’s first presidential victory – Mr Emanuel was his chief fundraiser – he began to reel off the names of those who had 'crossed' him. He grabbed a steak knife and began plunging it into the table shouting “Dead! Dead! Dead!” after each name.

“When he was done the table looked like a lunar landscape,” a witness relates. “It was like something out of The Godfather. But that’s Rahm for you.” http://www.timesonline.co.uk/tol/news/world/us_and_americas/us_elections/article5106463.ece

This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. Substantively, it suggests services that promote the continuation of the polity - those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations - are to be socially guaranteed as basic.

Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed.

An obvious example is not guaranteeing health services to patients with dementia.

A less obvious example Is is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason. http://www.ncpa.org/pdfs/Where_Civic_Republicanism_and_Deliberative_Democracy_Meet.pdf

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UPDATE: Emanuel met Wednesday with six disability advocates. He "sincerely apologized," again, for using the word, promising to sign an online pledge to end the use of the word, the advocates said in a joint statement.

Emanuel also promised to "examine" Congressional legislation that would remove the word from federal law.

"We are thankful to Mr. Emanuel for meeting with us today and hearing our concerns," said the joint statement from the six advocates whom he met, led by Shriver.

"Our community has earned the right to be respected instead of ridiculed. We have suffered injustice for generations and we are demanding that it end," the said in the statement. "This is another small step on the road to a country that accepts the gifts of all."

UPDATE: Seckler says that, today, the leaders did accept Emanuel's apology: "All six of the advocates, including Tim Shriver, accepted Rahm Emanuel’s apology on their own behalf and on behalf of the organizations they represent."