From The American Spectator (emphasis mine):

Dr. Ezekiel Emanuel, who is health-policy adviser at the Office of Management and Budget and a member of the Federal Council on Comparative Effectiveness Research as well as being White House Chief of Staff Rahm Emanuel’s brother, propounds discrimination against the elderly and other less-than-robust patients.
In the medical journal Lancet he wrote in January, “Unlike allocation by sex or race, allocation by age is not invidious [an irrelevancy] discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years.”
As for the less-than-robust, in a Hastings Center Report he has written that medical care be withheld from those “who are irreversibly prevented from being or becoming participating citizens. … An obvious example is not guaranteeing health services to patients with dementia.” Thus the state should decide when and if you get treatment. Does that not have a grisly ring to it?
Dr. Emanuel veers from the grisly to the delightfully frivolous in his pontifications on cost cuts. Savor this one from the Journal of the American Medical Associationin May of 2007: “Too much money spent on health care reduced [sic] the ability to obtain other essentials of human life as well as some goods and services not essential to life but still of great value, such as education, vacations, and the arts.” Yes, he said “vacations and the arts.”

Now, what kind of health care should be withheld from “participating citizens”? Pacemakers? Hip replacements? Tonsillectomies?
Penicillin?
And what’s the threshold for “participating”? Maybe we should have a way to see if people are really participating. Like a test!