At the forefront recently in the health care reform debate, end of life decision making has brought on some heated discussions. First it was former Alaska Governor Sarah Palin's insertion into the argument decrying the establishment of "death panels" to allow doctors to be paid for advising patients on end of life decisions, as advised by a panel of 'experts', though not medical people. This was immediately the cause of severe heartburn on the far left and at the White House as Palin was subjected to a new round of criticism for speaking out.
When all else fails, call your opponents names.
If there were no provisions for these 'death panels' then why has the part of the proposed legislation been eliminated by the Senate committee now working on a more bi-partisan approach?
Charles Krauthammer has a recent column out in the Washington Post titled, "The Truth About Death Counseling" and it rings true with me. If you have ever had to face the difficult decisions made at the end of the life of a loved one, you know that the trite way in which some speak of the process is very dishonest. Krauthammer writes, "But there are no "death panels" in the Democratic health care bills, and to say that there are is to debase the debate. We also have to tell the defenders of the notorious Section 1233 of H.R.3200 that it is not quite as benign as they pretend. To offer government reimbursement to any doctor who gives end-of-life counseling -- whether or not the patient asked for it -- is to create an incentive for such a chat."
Krauthammer goes on to describe living wills and that they are useful until you actually need to use them. The fact is that as a healthy person, a living will seems to make sense. Save the cost and prolongment of an ill loved one if that loved one doesn't want extraordinary measures taken to save life. However, once that person is actually at the point of the family using such guidance, often instructions can change. Living wills prolong life, for the most part, not extinguish life, as those thinking of them as a cost cutting instrument would have you believe.
Also not so prominent until now is the discussion of the Death Book for Veterans, as it is called. Jim Towey writes about it in The Wall Street Journal. Towey is president of Saint Vincent College, and he was director of the White House Office of Faith-based Initiatives from 2002-2006. He is founder of the nonprofit Aging with Dignity. The booklet is titled, "Your Life, Your Choices" and is distributed by the VA. "If President Obama is sincere in stating that he is not trying to cut costs by pressuring the disabled to forgo critical care, one good way to show that commitment is to walk two blocks from teh Oval Office and pull the plug on "Your Life, Your Choices. He should make sure in thefuture that VA decisions are guided by values that treat the lives of our veterans as gifts, not burdens."
You see, this booklet is currently being revised. It is also, however, back in force since President Obama ordered as he came into office. Under former President Bush, the use of the booklet was suspended by his order.
In the booklet, veterans are asked to consider if they are a burden on their family, if they are 'blue', if they are living in a nursing home, if they are using a wheelchair. All of these conditions are reasons for a person to end his/her life. The primary author, according to Mr. Towey, is Dr. Robert Pearlman, "chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S> Supreme Court and is known for his support of health-care rationing."
"I am not surprised to learn that the VA panel of experts that sought to update "Your Life, Your Choices" between 2007-2008 did not include any representatives of faith groups or disability rights advocates. As you might guess, only one organization was listed in the new version as a resource on advance directives: the Hemlock Society (now euphemistically known as "compassion and Choices").
Is hurry up and die the message we want to send to our veterans?
End of life decisions are gut-wrenching. In my own family, my mother was very ill for the last several years of her life. She lived in my home and I was her caregiver. As it became clear that her life was approaching the natural end, she requested a Do Not Resuscitate order be placed on her charts. It was her choice.