“Death panels” lie prevents dying with dignity

WASHINGTON — When Congress made its foolish 2005 foray   into the heartbreaking case of Terri Schiavo, the Florida woman kept alive for years in a vegetative state, I called my brother to reiterate my end-of-life directives. “Don’t let Mom interfere,” I told him sternly, knowing that parents can be irrational about letting go of a dying child.

My mother, however, is clear-eyed about her own demise. She, too, has assigned to my brother her medical care power of attorney, giving him legally-protected decision-making authority should she become too ill to issue instructions to a doctor.

Apparently, my mother and I are unusual. Though the certainty of death is one of the few things shared by every human, we tend to put off thinking about it. According to the Pew Research Center, only 29 percent of Americans reported having living wills in a 2006 poll. Even fewer have gone as far as my mother and I  — appointing a health care proxy.

Oddly, a loud and ill-informed band of activists has organized to make sure that Americans continue to procrastinate about end-of-life directives. In what has to be one of the strangest political battles fought in modern times, a motley assortment of Obama-haters, rightwing conspiracy theorists and Republican politicians have joined to ensure that more families struggle through painful Schiavo-like situations.

You may remember the infamous “death panels” fabrication, which reverberated through the political landscape in 2009. It was a falsehood jerry-rigged to a perfectly sane proposal — that Medicare pay doctors to ask patients a few questions: Have you thought about end-of-life directives? Do you want a living will?

The policy sought to take advantage of the great weakness of our health care system: it pays doctors for procedures, not outcomes. Given that, doctors would be more likely to raise the subject with patients if they were paid for the time they spent. If experience is any guide, patients are less likely to bring it up themselves. But any patient’s participation would have been purely voluntary. No one would have been forced to have the conversation.

From that thoughtful policy change, Sarah Palin and others spread the “death panels” lie, persuading millions of Americans that the federal government would empanel bureaucrats to decide when to “pull the plug on Granny.”

Because the falsehood proved so powerful, Democrats eliminated the end-of-life counseling provision from the health care reform bill passed last March. Medicare administrator Donald Berwick tried to resurrect the provision through a

directive from his office late last year, but he was overruled recently by Obama administration officials who feared more political controversy.

How sad. The irony is this: A failure to prepare for the inevitability of death ensures that doctors, nurses and hospital administrators will end up making end-of-life decisions for countless terminally ill patients. If patients feared losing their autonomy — the right to make a highly-charged and personal decision for themselves — they should have welcomed the new Medicare initiative. It makes sense to confront those matters while you’re still healthy enough to think clearly.

According to research published in the British Medical Journal, “Advance care planning improves end-of-life care and patient and family satisfaction and reduces stress, anxiety and depression in surviving relatives.” The research only confirms what common sense suggests.

When my father learned he had colon cancer— he was only 57 — he didn’t have much time to think about whether he wanted doctors to pursue extraordinary measures to keep him alive. His cancer had metastasized by the time it was discovered. He was dead seven weeks after diagnosis.

But he was fully cognizant — clear-headed and alert — for most of those final days, and he used the time wisely and well. He wrapped up duties at the church where he had served as a deacon for decades. He said good-bye to his children.

And he told my mother in no uncertain terms that he was ready to face the end. He wanted no extraordinary interventions. “Put me in a blue casket,” he said.

It was hard enough to lay my father to rest under those circumstances. I simply cannot imagine how painful it would have been if he been too sick to tell us how he wanted to die.

247 comments Add your comment

Keep up the good fight!

January 7th, 2011
1:15 pm

JKL…Hard to claim no playbook when the post links directly to the entire 28 page pdf playbook….

Kam thanks for the link.

JKL2

January 7th, 2011
1:15 pm

kevinbgoode- conservatives don’t believe there is any dignity in being poor

Thanks for explaining that. Maybe someone needs to tell all those illegal immigrants this is really the “Land of the Poor” and they’ll go home.

I think the best way of doing good to the poor, is not making them easy in poverty, but leading or driving them out of it. — Benjamin Franklin

Kamchak

January 7th, 2011
1:19 pm

It only took 43 comments to bring out that one.

It took only 1 comment from me to bring out my leg-humper.

JKL2

January 7th, 2011
1:19 pm

Keep- As to why it was needed in Federal law, I believe the consultation was not paid for in all states

Let’s raise taxes and make another federal law because people are too stupid to take care of themselves. They’ll never survive unless that government tells them what to do.

Logical Dude

January 7th, 2011
1:23 pm

How about common sense coverage from insurance companies? As it stands now, the Insurance companies are the death panel. It sounds like having the patient more engaged in the end-of-life decisions, the power is moved away from the insurance company and into the individual.

And why is that bad?

granny godzilla

January 7th, 2011
1:25 pm

Sell your possessions and give to charity; make yourselves purses which do not wear out, an unfailing treasure in heaven, where no thief comes near, nor moth destroys – Some poor guy from Nazareth

.WAKE-UP you fools READ THE BILLS for yourself.

January 7th, 2011
1:28 pm

People like CT can stand on the roof tops and say that it will never happen. Well maybe not to them. But what happens when the goverment decides the doctors will not be on the death pannels and they need special trained people to do it. Who is going to train these people.THE GOVERMENT WILL. What happens when the pannels decided that age is the only requirment for them to decide who dies. If some stranger can decieve a older person to clean out their bank accounts, how hard will it be for a person that the goverment says the people can trust, will help them to decide they are no longer needed on this earth. How many old people could the get to take the death pill just to help them out of their depresion? How many older people do you know that thinks they would be better off out of the way?
One other thing, there was not a death pannel provision in the bill the passed, how can they take some thing out if is was not in there?

Keep up the good fight!

January 7th, 2011
1:28 pm

JKL well first taxes were lowered by the law and repealing it would cost $230 billion

Second..”people too stupid to take care of themselves”…you mean like someone in a coma after an accident who, with proper planning and consultation, has a healthcare directive that says pull the plug…..yeah pretty silly I guess. Certainly better for everyone to leave them plugged in when they would have wanted otherwise. Expect them all to know how to fill out the forms and make the proper choices or even to know that there are forms…

granny godzilla

January 7th, 2011
1:29 pm

WAKE-UP you fools
READ THE BILLS for
yourself.

I figure you account for about half the posts here today.

Is my number a little high or a little low?

AngryRedMarsWoman

January 7th, 2011
1:32 pm

“conservatives don’t believe there is any dignity in being poor”

huh? I don’t see you saying that conservatives don’t believe that a poor person can be dignified, just that there is not dignity in the status of poverty…in other words, you should be proud that you work hard, but not have pride in the state of being poor. I don’t think there is anything wrong with that. When there are segments of society that believe it is “cool” to be on assistance or not work or just to be poor, then there is a problem. If a person is “scraping by” poor, he should be trying to find legal ways to change his situation for the better rather than looking for respect for his status….a poor person has dignity, but the state of being poor is nothing to be proud of.

kayaker 71

January 7th, 2011
1:44 pm

I certainly believe in living wills, members of the family designated as decision makers and proper decisions made by the decedent prior to buying the farm. Who ever said that the government should take part in this? The government has no business in the process of how I die, what decisions are made about my demise and how my family manages my death. In other words, I do not need the government’s help in decisions of this kind, not now, not ever.

Get Real

January 7th, 2011
1:45 pm

kevinbgoode January 7th, 2011 1:03 pm

Again painting conservatives with one broad brushstroke…..wrong

Granny and Nerve…both parties have sucked regarding fiscal responsibility. I am willing to give the new House majority more than 48 hours before I pass judgement on “lessons learned”. The jury is still out for most of us..

Keep up the good fight!

January 7th, 2011
1:46 pm

k71…. ummm all the government was doing was requiring that you had the option to go to your doctor and ask questions and the insurance would pay for that consultation.

The government never once has indicted it made the decision for you.

granny godzilla

January 7th, 2011
1:52 pm

Get Real

I would have given them more time too if they hadn’t come out of the shoot so badly with that 100 billion dollars in cuts now being “hyperbole” and the Speakers poor performance in the Brian Williams interview.

Get Real

January 7th, 2011
1:57 pm

Granny….I am still going to wait, I admit the $100 billion is disappointing but again the jury is still out, 48 hours is way too soon. Regarding the Williams interview, I have to admit that I have not seen it….will have to google it

AngryRedMarsWoman

January 7th, 2011
1:57 pm

“all the government was doing was requiring that you had the option to go to your doctor and ask questions and the insurance would pay for that consultation”

You know, I don’t have an issue with that but then again I do. I work in healthcare. I see a great big door opening for fraud and we all know there is enough of that already in healthcare. I can see an unscrupulous provider saying “Hi Jim, how you feeling? Do you have a living will? No? You should.” and checking the box to get paid for an “end of life counseling” visit. Such a discussion should just be part of the yearly wellness check-up – no additional payment needed. It would be like paying a physician for smoking cessation counseling when he tells his patient “you really should quit smoking.”

granny godzilla

January 7th, 2011
2:00 pm

Get Real

After campaigning as deficit hawks for over a year, and 60 days past the mid-terms he was still unable to be specific about which programs he thinks should be cut.

I take away points for showing up for the first day of work unprepared.

I’d say seriously under-prepared.

Keep up the good fight!

January 7th, 2011
2:06 pm

Well then Angry…you have auditors and certain requirements to confirm. Create whistleblower laws. Fearing fraud is not the answer. You implement checks and balances to be sure it is done properly. There are a great number of doctors who provide ethical service. Insurance companies can check just as they do checks to see if staff is providing all of the services providecd, and of course, “we all know” private industry can do this better than goverment, right?

JKL2

January 7th, 2011
2:14 pm

Keep- first taxes were lowered by the law and repealing it would cost $230 billion

I love that government accounting. It’s a cut because it didn’t go up as much as we wanted it to.

You realy believe any of this is going to save money? Nobody wants a cheeseburger until you tell them it’s free, then you have a line around the block. The Dem sent parameters to the CBO until the number was within the range they wanted it to be (under $1T). Problem is the last government program to come in on budget was Hoover Dam.

RomneyCare has bankrupted Massachusetts. Let’s extend it to everyone! What a good idea…

markie mark

January 7th, 2011
2:14 pm

Cynthia, I agree with most of your sentiment. However, I do not agree with your death panel statement. As Bookman and I agreed some weeks ago on his blog, there ARE death panels. Jay reluctantly agreed that in reality we have them. He just argues today that they are made of of individuals in insurance companies who make these life and death decisions. My viewpoint was that I have a better chance of arguing coverage with an insurance company than I do with a governmental entity in charge of making these financial and/or medical decisions.

AngryRedMarsWoman

January 7th, 2011
2:15 pm

They already exist, Keep. In fact, healthcare is awash with laws, regulations and related audits. I know there are a large number of physicians who are ethical – and as counsel to a larger healthcare company I can assure you that we tie ourselves into knots trying to stay on the right side of the myriad of laws and regulations that are many times unclear and sometimes ill-conceived. I also know that adding yet another level of reimbursement is not going to benefit the “good” doctors as much as it will open the door for fraud by the mills. I guess what I don’t understand is why this is a separately reimbursed service rather than part of a standard wellness visit for all old folks. If your doctor is not talking to you about your life in general when you come for a visit then you should find a new doctor, especially if you are over 40.

ctucker

January 7th, 2011
2:20 pm

Good Grief@11:37, What you heard were absolute and utter lies. The only “panel” was the patient and his/her doctor. No one else would have been involved

ctucker

January 7th, 2011
2:22 pm

Chris@11:48, I’m assuming you didn’t bother to read the post. If you had, you’d know that the only change made by a law was to have Medicare pay a doctor to bring the subject up with the patient. That was the entire “death panels” proposal.

ctucker

January 7th, 2011
2:24 pm

BeeJay@12:06, I’m sure you’re stuffed to the gills with FauxNews and WorldNetDaily, so there’s no room left for actual facts. But the only government involvement in the decision was having the government (that would be Medicare) pay the doctor to bring the subject up with patients.

George W

January 7th, 2011
2:24 pm

Tucker…..that day cannot come soon enough.

George W

January 7th, 2011
2:25 pm

I met with a CEO and CTO of a major hospital here in metro Atlanta. They are very much against Obama care. They were both Democrat leaning individuals but said this bill will bankrupt many private practice doctors and greatly deminish the care we now get in our local hospitals.

ctucker

January 7th, 2011
2:26 pm

Burroughston Broch@12:16, I’m sure you are also one of those who can’t be troubled by actual facts, but paying the doctor to “give the information and get out of the way” is exactly what the new proposal would have done.

ctucker

January 7th, 2011
2:27 pm

GetREal@12:20, The government intervened in the case of Terri Schiavo. (Were you troubled by that?) There is no government intervention in end-of-life counseling other than paying the doctor to ask you if you want a living will.

wtf?

January 7th, 2011
2:29 pm

It is well worth your time to do a little research on organ donation.

On the face it seems like the right hting to do, however, each year there are dozens of caes where someone (often time an hourly medical asst. or nurse has trmeendous say about who lives or dies. Often the scenario goes something like this: a person who may or may not have the same background,race, religion, staton in life, ect of the medical staff comes in after a car wreck where alcohol might or might not have been involved.

Down the hall is sweet young Jane Doe who is awaiting a new organ, who happens to go to the same church, school, college, ect, as the medical staffer. They either make or influence the decision that it be best to let Stranger Doe die so his/her organs can help Jane Doe who they are closer too. You can reseach this and you’ll be suprised how often this happens and how much (like anything these days) misguided good intentions and/or corruption are involved.

I’m not saying this always happens, but to me, life is so precious and to put the decsion to live or die in the hands of a stranger is the last thing I want. Someone playing God with my life? I don’t think so.

Thinnk twice before signing up for organ donation, it might be the most important decision you’ll ever make.

B

January 7th, 2011
2:30 pm

So let me get this right: you accuse republicans of “lying” about the fact that this horrid obamacare fiasco will indeed lead to some petty government bureaucrat making decisions about who qualifies for what types of care based on whether it’s cost effective or not. But you believe that the cooked CBO numbers will somehow magically lead obamacare to reduce the deficit.

Lord, what fools these mortal democrats be!

End-of-death counseling? No problem with that. But government sponsored/mandated “counseling”? How stupid do you think we are!?

Pretty damn dumb, obviously. That’s the point of this whole debate, Cynthia: we DO NOT want government meddling in our affairs. Period. Too damn much nanny state crap out there already! And you want more???? That’s quie frankly insane!

Oh, and your little rant about the “government takeover of healthcare” being a lie: of course it is a confiscation of our rights! When any damn peon is appointed to manipulate the decisions that individuals by right of being a citizen of this country shoul make him/herself, then that’s even more of the insane nanny state’s intrusion into our lives. We have far, far too much of it already and it’s about time that we reclaim our responsibilities as citizens, not cede yet more to Big Bro.

That’s what November was all about, but, of course, democrats are so steeped (like the proverbial dead frogs) of thinking that all this meddling is “necessary” that they’ll keep promoting the insanity and even more sadly, believe their drivel. Thank God the American people are smarter than these democrat “leaders.”.

AngryRedMarsWoman

January 7th, 2011
2:31 pm

“The government intervened in the case of Terri Schiavo. (Were you troubled by that?)” A million times, YES. That entire debacle was painful to watch. All it did was reinforce in my mind just how irrational most people are about dying when it comes to themselves or family members. Holy crap people, what is the problem here? If you are religious then you should welcome death so you/your loved one can go to heaven (or the destination of choice for your religion). If you are not religious, then what are you worried about? Everything comes to an end….except, apparently, The Simpsons.

Rafe Hollister

January 7th, 2011
2:33 pm

Sin-thee: It is called FREEDOM, not a word used much by Barry and the Chicago boys.

Yes, we should plan for the final decisions, but on our own time and in our own way. Freedom to do things our way. Freedom to do what is in our best interest, rather than let the decision be made by bureaucrats.

Get Real

January 7th, 2011
2:35 pm

Tucker…where do get that out of my 12:20 post?? Drs cannot draft living wills btw…

yuzeyurbrain

January 7th, 2011
2:37 pm

I don’t think it is purely a conservative v. liberal issue although opinions are probably weighted along those lines. It is a tough decision for anyone because we just don’t like to think about our own mortality. But it is the adult responsible thing to do. As to those that said just leave govt. out of it, I have news for you. The State of Georgia is deep in it already. There is a very detailed living will statute which you must follow if you want to be sure your wishes are followed. And that statute PROHIBITS medical or nursing home personnel from initiating a discussion of living wills. So Big Brother is already there, but on the side of those opposing living wills. And believe me, if you read every convuluted technical word in the statute, you will want to be able to ask your doctor what in the heck it means. So which side is enhancing the rights of the individual?

ctucker

January 7th, 2011
2:48 pm

GetRea@2:35: this is what you wrote: Why do we need the government to intervene with family/personal decisions? My question: What government intervention are you talking about? This is not about a doctor drafting anything. Did you read the post?

ctucker

January 7th, 2011
2:50 pm

B@2:30, There is no government mandated counseling. But you didn’t bother to read the post, did you?

ctucker

January 7th, 2011
2:50 pm

George W@2:25, If they said that, they are ignorant of the bill.

Logical Dude

January 7th, 2011
2:53 pm

wtf says “You can reseach this and you’ll be suprised how often this happens and how much (like anything these days) misguided good intentions and/or corruption are involved.”

The MAYO CLINIC SAYS:
Myth: If I agree to donate my organs, the hospital staff won’t work as hard to save my life.
Fact: When you go to the hospital for treatment, doctors focus on saving your life — not somebody else’s. You’ll be seen by a doctor whose specialty most closely matches your particular emergency. The doctor in charge of your care has nothing to do with transplantation.

Please, wft?, don’t spread misinformation about stuff that has saved my own life.

Dem Lies

January 7th, 2011
2:57 pm

Cynthia
As usual you just don’t get it. It’s not your decision or the governments on how a person decides to either get medical treatment or not. The government has NO business in the decision at all. A person can choose what they think is best for them and their family. You or Washington have no right to judge or decide for them. PERIOD.

Libby

January 7th, 2011
2:57 pm

Terry Schiavo was mis-diagnosed; course you liberals would never admit to any mistakes.

Way to go Scout!

Dan

January 7th, 2011
2:58 pm

No CT the doctor bringing up options is not even close to what was meant by the “death panels” comment. The comment illustrates the inevitable decision of when an end of life decision is made do to rationing as opposed to the patients wishes. Those decisions of course would be made by a gov employee or panel based on cost and availability ie death panel. A scenario that is common in other state sanctioned programs and inevitable in this one.

Dan

January 7th, 2011
3:00 pm

CT George is absolutely correct and anyone who has studied the bill such as health care actuaries and benefit management professionals will tell you that. Heck the speaker at the time said “we have to pass this to see whats in it. So most people are ignorant of the bill expcept for those whose job it is to implement the monstrosity

ctucker

January 7th, 2011
3:04 pm

Dan@2:58, If the doctor bringing up options is not what they meant, they were did death panels come from? Republicans in congress at the time said the reaction was in response to exactly that proposal. After all, there are no proposals for “rationing” in the new health care law. No government panels. No bureaucrats, unless you mean those employed by insurance companies.

Kamchak

January 7th, 2011
3:04 pm

Heck the speaker at the time said “we have to pass this to see whats in it.

The lie that will not die.

If you’re gonna put something in quotes, you really should verify the accuracy of your quote, sport.

ctucker

January 7th, 2011
3:04 pm

Dem Lies@2:57, you get an “F” for reading comprehension.

granny godzilla

January 7th, 2011
3:05 pm

Terry Schaivo was what?

David S

January 7th, 2011
3:06 pm

The FDA, the AMA, state license boards, the DEA, and others already act as death panels as they currently prohibit both the use and open education about natural and far more effective therapies to most of the diseases that BigPharma profits so heavily from. Just today the FDA moved to ban the manufacture of Vitamin C for intravenous use. You may not personally care to use this wonderful miracle compound but many have effectively battled burn damage and cancer with this vitamin. Intravenous injection is required for high doses because the digestive tract cannot handle amounts above 12g at a time. Personally I received a 50g IV of vitamin C once, it did no harm, and should have been my choice along with my doctor, not the “death panel” of the FDA. Medical marijuana has been shown in dozens of studies (some even by the NIH) to be quite medially effective yet the federal government currently bans it and has thrown many in jail for it. Peter McWilliams, the brilliant author was killed by the FDA/DEA death panel in just this manner. He died in prison without his medicine.

Anytime the government is involved in ANYTHING that is vital to life, their actions to restrict freedom will inevitably result in death.

Yes, Cynthia, there are DEATH PANELS. But they were there long before Obama Care set the wheels in motion for additional ones.

Logical Dude

January 7th, 2011
3:07 pm

Dan,
Can you quote the poion of legistlation that has the “death Panel” as you describe?

Otherwise, you misquoting Speaker Pelosi makes you lose a little credibility.

Otherwise, I agree that end of life decisions should be between a doctor and patient and family. The Republicans describing them as “death panels” does a disservice to anyone in this situation. If there was a real rationing of healthcare, then it should be described as such.

John Birch

January 7th, 2011
3:08 pm

I have a durable power of attorney for health care and a livving will but so what? Two more years of Obama and we’ll all be dead under an Iraninan mushroom cloud anyway!

stw

January 7th, 2011
3:09 pm

How can someone as ignorant of the facts as CT is continue to be allowed to preach her liberal dribble to the AJC readers (as few as there are now) ? When the liberals drive down the fees to doctors and throw everyone into the system it will be a death sentence to more than a few. We’ll see fewer doctors and more “freebie health care”…