“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

granny godzilla

January 7th, 2011
11:28 am

A Bronx cheer for the Obama administration for backing down on this.

Last year when our Mimi died in our arms in the back bedroom, the paramedics asked repeatedly about her wishes (she was gone by the time they arrived) but they offered to “work on her” for up to an hour if we wished.

Y’all get your living will done it’s easy and be an organ donor too.

[...] Read More… [...]

Scout

January 7th, 2011
11:32 am

Cynthia:

Maybe I’ll be on your death panel.

Billybob

January 7th, 2011
11:35 am

conservatives equal not dying with dignity…..you are losing it ma’am and have lost your dignity significantly earlier in life at the hands of this conservative……keep lashing out tucker, it always brightens my day to read how unhappy you always are(which is a typical liberal trait). Sorry about your mimi granny…..

Good Grief

January 7th, 2011
11:37 am

I agree that everyone should have their affairs in order, and as early as possible. None of us are promised tomorrow.

That said, my experience with the ‘death panel’ controversy was not the issue of asking what should be done. What I kept hearing, from people and pundits alike, was that these death panels would decide if treatment should continue, what would amount to a blatant rationing of care. The talking points I heard weren’t that these panels would help to plan out end-of-life care or wills, but they would decide if you received treatment or not.

Like you, though, CT, I’ve already told those who need to know how things should go for me.

ByteMe

January 7th, 2011
11:37 am

Great column! Of course, the crazy will still be crazy and refute any evidence to the contrary.

Billybob

January 7th, 2011
11:38 am

Another wall street guy in with Hussein…..Obama villifies wall street while becoming blood brothers with it behind closed doors, that should make you mad, right tucker?

Belinda

January 7th, 2011
11:39 am

I agree with you, Cynthia.

Chris

January 7th, 2011
11:40 am

Everyone should take on the responsibility to talk to their siblings about what to do in critical medical situations and to let your wishes be known. I just don’t understand why it needs to be a law like Ms. Tucker apparently advocates? Seems to me it could be done on our own.

Billybob

January 7th, 2011
11:40 am

Free market capitalism + socialist healthcare system = crazy

Billybob

January 7th, 2011
11:41 am

You are right Chris….

Keep up the good fight!

January 7th, 2011
11:42 am

End of life and health care directives have been recommended for years without question or controversy. Everyone should have them.

Keep up the good fight!

January 7th, 2011
11:44 am

Chris…it was never a requirement of law. It was an simple clarification that the costs of discussing these matters with your doctor so that yoou can make an informed decision as to what each involves would be a cost covered by insurance.

Scout

January 7th, 2011
11:53 am

Belinda:

That was brililant. Is there anything else we can expect from you today?

Keep up the good fight!

January 7th, 2011
12:04 pm

Maybe I’ll be on your death panel

What and this was so insightful?

Scout

January 7th, 2011
12:05 pm

Good Fight:

It’s a joke ……….. get it? A joke.

BeeJay

January 7th, 2011
12:06 pm

Yes, it is helpful if people would deal with health matters before the need arises, but their doing so is THEIR business, NOT the government’s. And certainly not the business of the supreme government of Obama Empire. I’m sure you know as well as everyone else does the purpose of the government getting involved in this private subject; rationing of life-saving procedures and medications is already in force elsewhere. Since the government is going to be paying for health care, to the detriment of us all, they must decide what health care is NOT going to be paid for, and it is among the “elderly” first. It has nothing to do with quality of life and everything to do with money. I hope when you reach this point in your pathetic life, you understand what they’re doing.

You, madam, as usual, distort the subject just to have something inflammatory to write. You are a disgrace to journalism and to the truth.

Scout

January 7th, 2011
12:07 pm

Good Fight:

Regarding “insightful”, I’m working on a full transcript of the Chris Matthews segment.

I’ll be in touch.

Keep up the good fight!

January 7th, 2011
12:08 pm

So was mine Scout…..a joke about your post. ;)

Road Scholar

January 7th, 2011
12:09 pm

Scout: That was callous! You should be ashamed! You are better than that.

Billybob: Bless your heart!

You have to be able to talk to your doctor about treatments, and the quality of life that each treatment will allow. While nothing is 100%, you have to rely on the history of those who have been treated before you.

Get Real

January 7th, 2011
12:11 pm

So this is where everyone went…too busy to keep up today..

Ragnar Danneskjöld

January 7th, 2011
12:11 pm

Good afternoon all. Our leftist friends are injured by any talk of “death panels” as that is the inevitable logical end of all of the “promises” (of cost controls) resident in ObamaCare. Nevertheless, there is something weird about the political cult of death in that it would compensate all physicians for annually discussing alternatives to “living.” Sounds like one of their push-polls.

Burroughston Broch

January 7th, 2011
12:16 pm

Cynthia ignored the real point, which I just went through with my father.
The real point is that we all can decide whether to have an end-of-life directive.
I will ask for information but I do not want to be pushed by government employees incentivized to reduce healthcare costs by making me die sooner and cheaper.
Just give me the information and then get out of the way.

Scout

January 7th, 2011
12:16 pm

Road Scholar:

I’m sorry.

I repent in sackcloth and ashes.

Keep up the good fight!

January 7th, 2011
12:17 pm

Nevertheless, there is something weird about the political cult of death in that it would compensate all physicians for annually discussing alternatives to “living.”

Did not seem weird to the Republicans when discussing Terry Schiavo.

Its not alternatives to living, its about the quality of living and letting those who you love and those who care for you about how you want to live.

Get Real

January 7th, 2011
12:20 pm

Why do we need the government to intervene with family/personal decisions? Am I delusional or should these discussion not be taking place with family and with your physician without a law dictating as such. If you require the government to tell you to do common sense things then you are hopelessly lost anyway…..

Keep up the good fight!

January 7th, 2011
12:20 pm

Borch and anyone who wants to claim that there was a “death panel”

Do point to the precise language in the original bill or the law as passed that created any death panel. Obtaining information about life and health directives for informed decisions is not anything more than that…someone to answer the questions you may have and to help you know how to fill out a form with your choices so that you dont have to retain an attorney.

Keep up the good fight!

January 7th, 2011
12:22 pm

Real…it was not a requirement, it was an option available to those who want assistance or information.

granny godzilla

January 7th, 2011
12:24 pm

Get Real

The only involvment from the government would have been to insure that the doctors time was paid for as with any other doctors visit.

That’s a pretty damend good idea.

Jack

January 7th, 2011
12:29 pm

Rumor has it that Tucker voted GOP last November 2nd. So all this anti-GOP goop is for appearances only.

granny godzilla

January 7th, 2011
12:30 pm

speaking of rumors…is that two weeks on, one week off schedule for Speaker Boehners House real?

Get Real

January 7th, 2011
12:34 pm

Keep..Granny…no argument

John K

January 7th, 2011
12:38 pm

Today’s conservatives need fear to survive. Why bother with reality when “Obama’s gonna kill ya!” works so much better?

Logical Dude

January 7th, 2011
12:42 pm

Just letting everyone know:

If i get in a coma, vegetative state, or am otherwise incommunicado in a way not medically induced, DO EVERYTHING medically possible to keep me alive.

Now if I am STILL in a coma, vegetative state, or am otherwise incommunicado in a way not medically induced after THREE MONTHS AND THREE DAYS, then pull the plug.

I figure that’s enough time if my soul wants to come back for my body or not. This definitive time period removes doubt from my loved ones not to hang on to a mostly hopeless situation. Plus, it keeps the bills from getting too overwhelming and burdening my family for when my time comes.

Now, how do you write this into a living will? How do insurance companies view living wills, and will they cover my own choices, or will they “cut me off” because of my requests? “Well, if you WANT to die, we’ll just stop benefits after 1 month, and leave your family a huge amount of debt”. That’s one of the difficulties of creating a living will. I want to put in many conditions that are dependent on several teams of responsibility: My Family, My Doctor, My Insurance.

Of course, posting anonymously doesn’t help me resovle this, either!

Get Real

January 7th, 2011
12:42 pm

John K

Don’t paint conservatives with a broad brushstroke

Where'd Cindy Sheehan Go?

January 7th, 2011
12:44 pm

resno2

January 7th, 2011
12:51 pm

“The only involvment from the government would have been to insure that the doctors time was paid for as with any other doctors visit.”

They already do… it’s billed as a consultation.

So why make it a law?

JKL2

January 7th, 2011
12:56 pm

Not sure what the two have to do with each other. The death panel is still going to decide to pull the plug wether you want them to or not. The only thing this does is help them out by having “do not resuscitate” people move to the head of the line.

Get Real

January 7th, 2011
12:57 pm

resno2…..that is kind of what I was thinking….

AngryRedMarsWoman

January 7th, 2011
12:58 pm

Everyone should care enough about their loved ones to have end-of-life care issues sorted in advance. I have had a living will and healthcare proxy since I was in my mid-20s (before marriage and children even). Beyond that, what appears to really scare people is the idea that when they are old they will be denied healthcare. With 25%+ of your lifetime healthcare expenses being incurred in the last year of life, most likely on treatments that will simply keep you alive rather than give you any quality of life, I have to wonder about the sanity of those expenses. If you asked me to choose between spending $100k+ to keep me in the fetal position in a hospital bed hooked up to machines and getting cancer treatment for a 30 year old…well, to me at least, the choice is clear. Healthcare is not an infinite resource. A dollar spent on one person is naturally a dollar less spent on another. There is only so much to go around. I have very clear directives – when the machines are keeping me alive with no real chance of change, harvest the organs and unplug me and let me go…then burn me up so I don’t waste any space. Cheers to all.

Scout

January 7th, 2011
12:59 pm

Cynthia:

Your thread is not getting much volume.

I’m outta here and over to Bookman.

JKL2

January 7th, 2011
12:59 pm

john k-Why bother with reality when “Obama’s gonna kill ya!” works so much better?

Obama doesn’t have the ability to make complicated decisions like that. The opinion poll would have to be really high before he would even consider such a thing.

Kamchak

January 7th, 2011
1:01 pm

kevinbgoode

January 7th, 2011
1:03 pm

Since conservatives don’t believe there is any dignity in being poor, it is hard to believe that they’d consider any dignity when it comes to a poor person’s death. As they tell us over and over again, “successful” people are wealthy – the poor only exist as a barometer for those “successful” people to gauge “success” by, and that is dignity enough for the lower classes. After all, no one is poor unless they are lazy and stupid.

Keep up the good fight!

January 7th, 2011
1:07 pm

Scout must have missed the puppet theater addon tothis blog which makes us all blog for his entertainment.

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

Some People are misinformed

January 7th, 2011
1:09 pm

The misinformation on this blog is rampant as usual.

The law was not that you had to get end of life counseling, it was if you did get it, your insurance would pay for it. There is nothing about deciding when to pull the plug or your granny. It has nothing to do with rationing.

granny godzilla

January 7th, 2011
1:09 pm

Why make it a law.

Can tell you for sure, but I’d be willing to guess that some insurance providers wouldn’t pay for the consultation.

Our experience with our dear late Mimi and now with Pop staying with us for the winter has been that the doctor brought the subject up as part of the discussions during routine exams.

JKL2

January 7th, 2011
1:09 pm

kamchak-

Republican playbook–SQUIRREL

It only took 43 comments to bring out that one.

The Nerve

January 7th, 2011
1:11 pm

I had to read this several times to make sure my eyes weren’t deceiving me. A liberal preaching personal responsibility on something?!?!?!?! What a novel idea. Take responsibility for yourself and your family.

Maybe their is hope yet.

granny godzilla

January 7th, 2011
1:12 pm

The Nerve

I know….it’s like a conservative preaching fiscal responsibility!