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At the Threshold of Equality and Freedom

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Our nation has arrived at a fateful moment in the debate over health insurance reform. More than sixty years after Harry Truman recognized the health of all Americans as a public responsibility, we stand on the threshold, closer than ever to transforming our health insurance system into one that cares for all citizens and honors patient choice.

To step over that threshold we must acknowledge the current system divides us arbitrarily into haves and have-nots and only through united support for each other can we achieve our greatness. Health insurance reform can bring America closer to our ideals of equality and freedom if it offers affordable coverage to all, expands choices and puts each of us in charge of our health care decisions.

At Compassion & Choices, we focus on better care and informed decision making for patients facing the end of life and their families. We fight bills that would force patients to endure futile, invasive treatment against their will. We help clients with advance directives, local service referrals, and pain and symptom management. We were happy when legislators from both parties sponsored a provision to reimburse doctors whose Medicare patients ask to discuss end-of-life choices. This is the now famous Section 1233 on page 425 of House Bill 3200.

When seniors tell their doctor what treatments they would want or not want in a given situation, they protect their families from struggles over decisions about life-sustaining treatment if they became unable to speak for themselves. They protect their families from the kind of strife the Schiavo family endured.

So when patients express their decisions to their doctors, who stands to lose? The same people we saw demonstrating on the lawn of Terri Schiavo's hospice. Notorious anti-choice radical Randall Terry and others who would dictate private decisions for others: radicals who want to impose their religious beliefs on all Americans. Let's be honest, a medical-industrial complex that profits from extraordinary treatments even when they are harmful, painful and futile also benefits when a dying patient's wish for a peaceful end goes unspoken.

Opponents of health insurance reform are now spreading distortions -- including outrageous lies about the government encouraging seniors to end their lives and death panels euthanizing people with disabilities.

No facts support these horror stories. Even Fred Thompson, who first made these claims on his radio show, now admits, "Is this a conspiracy to kill off granny? No. Will seniors be forced to make decisions they don't want to make? No." Regardless of the facts, however, many people embrace these fears and cling to these myths. We shouldn't be surprised. Change of any kind is inherently frightening.

And what we're talking about is a profound change, from a system where bosses and insurance executives decide who gets health care coverage to one where each of us gets to choose; from a system where pharmaceutical representatives have first access to doctors to one where patients do. Having an opportunity to speak for ourselves on the most basic questions of life and death liberates us from dependence on others to dictate what is right for us.

Freedom is the change that feeds the fear. When we have a greater voice in health care, the traditional voices of authority lose their power over us. Note that when opponents acknowledge the truth, as Fred Thompson does, they still oppose patients discussing end-of-life choices with their doctors. The possibility that Americans could have a direct discussion with their doctor, unencumbered by issues of job or status, void of interference from medical vendors and without a requirement to follow the opinion of religious authorities, is a threat to all those who favor an authoritarian model of medical care.

We are passing through a sweltering August of discouragement, but must look ahead to the invigorating cool of a shaded haven, where our health care system might offer equality of access and freedom of choice and where patients -- not profits -- come first. It is within our sight; the door stands open. But those who fear progress stand in the way. By intimidation, with seeds of doubt and fear they are trying to bar our entry. This autumn, walking shoulder to shoulder, we can, we must cross that threshold.

 
 
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03:22 PM on 08/13/2009
I feel like we're at the end of the trilogy Lord of the Rings and the American citizen who wants reform is Sam Wise yelling and begging Frodo to throw the ring into the abyss of flaming lava to rid ourselves of this evil of profits before humanity.

And instead of hurling the ring, Frodo puts it on and says, "No."

We're going to all die wearing that ring if we don't find a way to throw it into the flames.

The answer isn't NO or precious, the answer is YES. Yes we can.

Frodo lives.

Viva La Liberte !!
03:35 PM on 08/13/2009
Um...Okay....what that has to do with end of life care or decision making is going over my head
06:56 AM on 08/14/2009
You're unaware of a profit motive for the elderly ?
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12:11 PM on 08/13/2009
I am unfamiliar of any patient undergoing a treatment against their will as the writer alleges. Is there an example of someone being forced into a "futile, invasive treatment against their will?"
12:28 PM on 08/13/2009
Many many people who do not have living wills/advanced directives are put on life support, which in some cases requires surgery, against their will, when a family member decides to extend the "life" (and I use the term loosely) of a critically ill or terminally ill patient when said patient can not speak for themself
12:30 PM on 08/13/2009
And even living wills/ADs can be challenged by family members to force a patient's "life" (again using the term loosely) to be extended against their will when they would have otherwise chosen DNR
07:49 AM on 08/13/2009
What happened with Terri Schiavo is something that could happen to any of us and it brings into focus the very real struggle that all famiiies will have to confront unless they are somehow very lucky.

If Terri had indeed signed "A living will" these unfortunate events would not have happened.

But it's a lot less "cut and dried" as some liberals want us all to believe.

Some folks now do survive the "Coma or
08:50 AM on 08/13/2009
Some folks do survive a coma.

Now what really bothers me is that the same folks who are so very quick to deny that an unborn child is alive are the very same folks who deny that a heartbeat, pulse and respiration are signs of life. Thank God that EMT's have a different viewpoint! And what about others who clinically die on the table with no heartbeat, pulse or respiration and come back to tell of a near death experience that was good or frightening. And these folks who have NDE's or near death experiences are not rare at all.
10:29 AM on 08/13/2009
a heartbeat, pulse and respiration are signs of life.

Sure, but the ability to communicate isn't considered by some to be a sign of intelligent life, otherwise dogs, cats, dolphins, hell, every animal on earth would be considered a form of life equal to humans. Just because we can't understand their language (yet) does not necessarily mean they are any less intelligent

HuffPo itself had an article that cited research that claims that dogs have the same cognitive and learning abilities as 2 year old humans.

But, that isn't the point here. The point is that those who oppose pulling the plug, or abortion don't give a flying flip about QUALITY of life in this world. As much as you might occasionally cite pseudoscience, obviously you've forgotten or likely ignored the fact that there are 2 nervous systems, one that controls heartbeat, pulse, respiration, the other that controls higher brain functions like speech and cognitive ability
10:31 AM on 08/13/2009
Continued

By your definition of heartbeat, pulse, respiration, ALL life is precious, from humans down to the tiniest little micro-organism, and if we keep the human alive, we should keep the flu virus alive.

In other words, havng a pulse, heartbeat and respiration is not the only, and in fact is not the most accurate definition of life, coming from people who believe that humans are not even animals, and that they have "dominion over the earth"
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SelenicMagick
Old, grouchy, toothless, sub-human bridge-dweller
11:25 AM on 08/13/2009
Whitney Cerak is an excellent example of someone who survived a mite more than just a coma... "she" had been declared dead, "she" had been buried... fortunately for her family it was one of the most bizarre cases of mistaken identity you will ever hear about. GOOGLE her... I'm telling you, you NEED to google Whitney.

While Terri would likely have benefited from having a living will the reality is that her parents have stated both on and off the record that they would have taken the matter to court even if she HAD a living will. Oddly enough, MANY courts today ignore the express wishes of the patient as detailed in their living wills.

The problem is NOT surviving...
~It is how people define "life"... definitions vary widely and there are millions of us who do NOT consider being hooked up to machines for years on end to be either "LIFE" or "LIVING". Matter of fact... for MANY of us it sounds more like H*LL than it does LIFE.

~It is how the medical community plays God... Don't believe me? Get a diagnosis of cancer and inform your doctor that you are opting for NO treatment... You'll be standing before a judge and be being ordered to undergo chemo so fast it will make your head spin.
02:48 AM on 08/13/2009
CORPORATE-SPONSORED PROPAGANDISTS create the
most-important weapons of all--FEAR and CHAOS.

Corporations PERFECTED advertising years ago.
They KNOW how to use it FOR CORPORATE PROFIT.

People forget that we're dealing with CORPORATE PROFITEERS
whose BOTTOM LINE is much more important than Your Health.
10:39 PM on 08/12/2009
First off, Ms Lee Coombs, allow me to personally thank you for the work you do and have done for and with Compassion and Choices. Your organization is an invaluable resource for those of us who have faced or will face eminent end-of-life care decisions. I can not express my gratitude to you and your organization enough for the knowledge that I have gained, and the resulting comfort that I now possess, knowing that when the time comes, I and I alone will have the control of my life and/or death.

Regardless of what options I might choose, the simple fact that there are options that can be discussed, and that these discussions are supported by at least some doctors can give a terminally ill patient the peace of mind to continue to fight for their very lives, if they so choose.

I am ashamed and disheartened at how this provision of the bill has been twisted and distorted to serve nothing more than the political advancement agendas of our current batch of legislators, on both sides of the aisle.

Again, thank you for your service and the work you do! And for those who need the link again to your organization,

Compassionandchoices.com
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elbzee
Fear is the mind-killer
08:58 AM on 08/13/2009
Well said PlaceboStudmen.

I have, on several occasions, been involved with Hospice care for loved ones. The good they do is immeasurable.
schatsie
banks are more dangerous than standing armies
10:02 PM on 08/12/2009
I will never ever forget the Doctor in Sicko who talked about making denials and knowing that they resulted in deaths..... She was heartsick and broken....and she was not as desparate as the 400,000 people who have lost their homes to unaffordable health bills this year and every year....

this healthcare system is a sickness. and spending more money willl just take down the rest of our society...