So much for Obama's denials about rationing for old people
If President Obama wants to better understand why America's discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Department of Veterans Affairs (VA). He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.
Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."
Who is the primary author of this workbook? 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.
"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political "push poll." For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be "not worth living."
The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to "shake the blues." There is a section which provocatively asks, "Have you ever heard anyone say, 'If I'm a vegetable, pull the plug'?" There also are guilt-inducing scenarios such as "I can no longer contribute to my family's well being," "I am a severe financial burden on my family" and that the vet's situation "causes severe emotional burden for my family." . . . .
"This is a slippery slope," he said Sunday. "When you look at the book it makes people feel like they're a burden and they should do the decent thing and die. ... When a veteran comes back from Iraq, they shouldn't be given a book like this."
Towey called the guide "fundamentally flawed" and said it should be pulled from the Web site. . . . .
[Tammy Duckworth, assistant secretary for the Department of Veterans Affairs] said it was one of many options for injured veterans, calling it "simply a tool."
"This ultimately is about the ... health care for veterans," Duckworth said.
Though Duckworth said the document has not been fully vetted, an official directive from July tells VA health practitioners to refer veterans to the document. Duckworth questioned whether that directive had been authorized at the highest levels. . . .
For another discussion see this.