Death, Dishonesty and the GOP

In an effort to defeat universal health care, conservatives are engaging in a campaign of lies that will ultimately cause more families to suffer needlessly at a most painful time. As someone who worked for years with end-of-life care issues, and spent years working in the HIV/AIDS community, I cannot let it pass.

It's easy to play on people's fear of death. It's even easier when you're willing to lie outright, as conservatives are doing in the health care debate.

A campaign on conservative talk radio, fueled by President Obama's calls to control exorbitant medical bills, has sparked fear among senior citizens that the health-care bill moving through Congress will lead to end-of-life "rationing" and even "euthanasia."

The controversy stems from a proposal to pay physicians who counsel elderly or terminally ill patients about what medical interventions they would prefer near the end of life and how to prepare instructions such as living wills. Under the plan, Medicare would reimburse doctors for one session every five years to confer with a patient about his or her wishes and how to ensure those preferences are followed. The counseling sessions would be voluntary.

But on right-leaning radio programs, religious e-mail lists and Internet blogs, the proposal has been described as "guiding you in how to die," "an ORDER from the Government to end your life," promoting "death care" and, in the words of antiabortion leader Randall Terry, an attempt to "kill Granny."

Though the counseling provision is a tiny part of a behemoth bill, the skirmish over end-of-life care, like arguments about abortion coverage, has become a distraction and provided an opening for opponents of the president's broader health-care agenda. At a forum sponsored by the seniors group AARP that was intended to pitch comprehensive reform, Obama was asked about the "rumors." He used the question to promote living wills, noting that he and the first lady have them.

Democratic strategists privately acknowledged that they were hesitant to give extra attention to the issue by refuting the inaccuracies, but they worry that it will further agitate already-skeptical seniors.

Where the consequence is needless suffering, I do not share Democratic strategists hesitance to refute inaccuracies.

That anyone would direct your doctor in "guiding you in how to die" is a lie.

That it amounts to "an ORDER from the Government to end your life" is a lie.

The truth is not that Democrats want to "kill Granny," but that Republicans want to ensure that "Granny" suffers needlessly in death, and that her family -- in the midst of their pain -- deal with the confusion of not knowing what kind of care "Granny" does or doesn't want, and what kind of measures she does and doesn't want taken.

Only a party that believes the Terri Schiavo spectacle was a boon to their cause could engage in a campaign to virtually ensure that many, many more such cases will happen -- though most will not play out before news cameras, or serve as a political sideshow for the extreme right. They are risking the same result they got from the Schiavo story -- that even more Americans will be appalled at a crass, politically driven intrusion into a deeply personal matter.

Grandma will die, someday. So will we all. It's perhaps the one indisputable reality every single person on earth has in common. We don't, however, like to think about it. So we don't think about it until it's too late, and our families suffer as a result. Republicans seem to want to make sure that continues to be true.

That's because the measure they're exploiting to defeat health care reform is really intended to facilitate more people getting advance directives. An advance directive is simply a document that serves to state what medical treatments you want or don't want, and what measure you do or do not want taken if you are unable to make medical decisions for yourself. In other words it speaks for you when you cannot speak for yourself.

In addition, a medical power power of attorney allows you to designate someone you trust to make medical decisions for you if you are unable to make them yourself.

The question isn't "How do you want to die?" The question is simply: "What kind of care do you want, and what measures do you want taken if -- at the end of life -- you are unable to speak for yourself?"

It's a decision that, in the absence of an advance directive or a living will, falls to a spouse or the closest family members. In the absence of an advance directive and/or medical power of attorney, families are often torn apart with fighting over their loved-ones wishes and trying to determine what those wishes were, leading to years of courtroom battles, while their loved one lingers.

Health care reform advocates don't want to "Kill Granny." Neither do conservatives. I'll even give them the benefit of the doubt that they don't want your family battling it out over Granny's hospital bed, or in court for years and years, as Granny lies there, no longer able to say what she wants. But that's the ultimate outcome of their dishonest campaign.

I saw it up close and personal when I volunteered in the HIV/AIDS community while in college. I saw partners who had spent decades together, and spent years caring for one another, kept apart because they were "not family" and had no legal standing that anyone was obligated to recognize. One man knocked on the door of the organization where I worked, and when I answered told me with tears in his eyes that he had just been barred from his partner's bedside by the man's estranged family, and even ejected from the home the two of them had shared. He had no legal standing as a spouse, of course, and the couple had no legal documents that might have given him the right be there.

Legal spouses don't have that problem. The reason that 30 or more courts ruled in Michael Schiavo's favor is because he was the legal spouse. Without even the legal status of having a medical power of attorney, let alone being legally married, the people whose pain I witnessed were extremely vulnerable. Even couples who have those documents, like Janice Langbehn and Lisa Pond, are vulnerable if they travel -- or go anywhere at all -- without them.

My husband and I both have advance directives stating what measures we want and don't want taken, in the event that we are unable to make those decisions ourselves. We each have medical powers of attorney, designating one of us to make make medical decisions for the other, if either of us is unable to make those decisions for ourselves. We have them because our experience has taught us how necessary they are, and the consequences of not having them. We have them because we know how vulnerable we are, and how vulnerable our children are without them.

The truth is that most Americans are vulnerable in this regard. According to a FindLaw.Com survey, 67 percent of Americans don't have a living will. That means more than two-thirds of Americans may have little to no say in the care they receive or the measures that are taken if they are terminally ill and/or incapacitated.

That's perhaps one of the worst aspects of the Republican's dishonest campaign. It has the potential to make people even more vulnerable, not merely by leaving their wishes undocumented, but by using fear to discourage people from even talking about this most personal decision with one of the most appropriate people: their doctor. After all, a personal physician who knows her patient's wishes, can be an effective advocate and help family understand the most compassionate ways to honor their loved one's wishes.

That's why, wherever you stand on health care reform, I urge you to please use this as a "teachable moment." Sit down with your doctor and/or your family now -- while you can still speak to them and they can still hear you -- and talk about what care you want and don't want, and what measures you do or don't want taken, if you are ill or injured and unable to speak for yourself. Talk about who you want to make decisions for you if you are unable to speak for yourself.

Make sure you have an advance directive. (You can download copies of your state's advance directive forms here.) Make sure you have a medical power of attorney. Make sure everyone knows.

At the same time, don't let the right insert politics into a matter that's ultimately between you, your family and your doctor. The measure that members of the conservative fringe are exploiting in the process does nothing more than encourage doctors and patients to have that most important, most avoided conversation.

They're lying as a means to a political end, and it will cause more families to suffer needlessly. It's not just inaccurate. It's not just wrong. It's immoral.

 

 

Follow Terrance Heath on Twitter: www.twitter.com/TerranceDC

Comments

[bannorhill]

Who ia being dishonest?

1) Obama Promise "Too often bills are rushed through Congress and to the president before the public has the opportunity to review them."
Look at the Stimulus bill.

2) Promise "Shine Light on Earmarks and Pork Barrel Spending: Obama's Transparency and Integrity in Earmarks Act will shed light on all earmarks" and "Cut Pork Barrel Spending:"
17,000 items of Pork and this has not happened.

3) Promise "Make White House Communications Public: Obama will amend executive orders to ensure that communications about regulatory policymaking between persons outside government and all White House staff are disclosed to the public. "
Obama's secret meetings with the health care industry.

4) Promise "Line-by-Line Review of Spending: Barack Obama and Joe Biden will conduct an exhaustive line-by-line review of the federal budget, work to eliminate government programs that are not performing, and demand that new initiatives be selected on the basis of their merits "
The stimulus bill.

5) Promise " Provide a Making Work Pay Tax Cut for America's Working Families". Obama proposes to add $2,000.00 tax on every family with Cap and trade.

6) Promise "Reinstate PAYGO Rules: Obama and Biden believe that a critical step in restoring fiscal discipline is enforcing pay-as-you-go (PAYGO) budgeting rules which require new spending commitments or tax changes to be paid for by cuts to other programs or new revenue."
$1,500,000­,000,000.0­0 NEW deficit.

See Change.Gov

[Neico]

How is this related to healthcare reform? You write these talking points that are baseless and unfounded. Are your talking points fact or something that the opposition told you to write. Okay, when the Bush administration OMITTED the two wars they created and not include the costs, where did the money come from to fight those wars? Did it come from your private stash?

Stop using talking points and get facts. Oh by the way, we are talking healthcare here.

[peterg76]

"hesitant to... by refuting the inaccuracies"

What is it going to take for Democrats to *learn*?

[GardenerNorCal]

End of life is something we should all discuss with our families and loved ones no matter what age. During those discussions make clear what you see as extraordinary and what you consider supportive. Some see oxygen through canula and nutrition and fluids as extraordinary. Personally I see them as supportive and humane care.

Don't just gloss it over when it becomes the focus of your life because it involves yourself or a loved one you will realize just how important it is.

[Nomccain]

After 8 years of the Bushes, and after what the Republicans have done relative to health care reform and other issues, I've decided they have become a party of LIARS! I no longer trust anything they say because they've proven that they're more motivated by power and politics than the good of this country or it's citizens. They've also proven that they'll do almost anything, legal or not, honest or not, to gain power.

[HenryDavid]

Yes, everyone deserves to have end-of-life counselling, whether they have health insurance or not. Debate about, and opposition to, that clause in the proposed health plan is just a smokescreen which delays passage.

A note on the relevant issues here--living wills and end-of-life choices. We Americans do not handle the issues of aging, disease, and death very well. We avoid thinking about them, often too long, and we become victims of the state and medical establishment who would choose to keep us alive by any artificial means possible. That could easily include putting electric paddles on the chest of a 90-year-old person with advanced dementia and in coma.

I was a full-time caregiver for my mother who had dementia. We didn’t talk about living wills, probably because I didn’t want to think about her dying. We were watching PBS one night, and by chance a program came on about prolonging life through respirators etc. She had been silent but suddenly spoke up, “I wouldn’t want that.” Sensitive to her wishes, I said, “Then we should speak with your doctor.” And we did. I’m so glad that I could help fulfill her choice. I want to have that same choice.

My wife and I have living wills to make full decisions for each should the occasion arise.
Do yourself and your loved ones a giant favor and get this paperwork done right away. Otherwise, the state could determine your future.

[soupson52]

Amen! It was very difficult to talk to my dad after he was diagnosed with cancer and yet I knew his greatest fear was suffering needlessly from cancer when chances of being cured were zero.

[Terrance Heath - Huffpost Blogger]

The problem is that, in cases like that, if a person's wishes aren't spelled out in a legal document, the hospital may be obligated to take measures that the patient doesn't want. If they cannot verify the patient's wishes, then they may be obligated to take take certain measures that might actually be against the patients wishes. But in some cases hospitals have to do that to protect themselves.

[Terrance Heath - Huffpost Blogger]

It's not just the medical establishment. Family members, in the absence of documents stating a patient's wishes, may demand measures the patient wouldn't want and would object to if she could speak for herself.

That's why it's important to have that discussion with family and with one's doctor.

[Articulator]

After closely watching the last 3 presidential elections, it is clear that the right wingers will lie and deceive at will. Just listen to Rush for about a minute and a half and you will hear no end of delusional fantasy. Seriously, did you know that the economic woes of this country are really the result of a big liberal plan to have the govt take over your lives? - please! But it is effective because there are people that suck that trash in like lemmings.

[HenryDavid]

Limbaugh is simply an entertainer who has found a big audience. He makes at least $30 million a year and avoided military service through some medical scam which he now disavows. He has done nothing for the country, but has simply taken from it. I don't understand how anyone could listen to him. However, the fact that he has such a large audience shows how disenfranchised so many millions of people feel.

[bannorhill]

What about Obama's lies to get elected?

[Katiebar]

This is a red herring. Truth be told, when you make something appear to be free, people will use more of it. Using more of it casues shortages. This is just the way it works. There will be a shortage of doctors, hospitals, and quality care with any government run system. And when that belt tightening "rationing" begins, who will pay the price? The elderly, the less productive members of our society. You, and all of the people you know ,will eventually fall under the judgemental eye of a bureaucrat with a budget to keep. The language they are already using is to provide a system that removes the "guilt- caring" for an elderly family member. That's right, no more "guilt-caring". You will no longer have to worry about spending a ton of money just to keep Mom alive another 3 years. No sir, now we will have the government deciding her fate, and you can sleep soundly at night.

[melodramy]

I am not using "more health care" just because I am covered, are you?: Why would anyone else do so in your fantasy scenario? In fact on the contrary, you'd think at the premiums I'm paying I'd be in there every day making sure I'm getting * my money's worth *, instead of sending into a black hole, but you know what, that has never occured to me. You know why? Because I'm not sick? Doctors and hospitals are not some bizarre new form of entertainment everyone enjoys wasting their time upon?

Thanks for repeating the lies, with no comprehension whatsoever that "the government" is not deciding anyone's fate - the individual is being given paid access to her doctor's counsel on how to go about making her advance directives official, as a paid covered benefit, so she does not have to pay out of pocket to get the same info from a lawyer.

Good job, very nice, so much LIE and FAIL in one post.

[soupson52]

I will second your statements. Thanks.

[GardenerNorCal]

There is a shortage of medical professionals because the for profit health industry limits how many people can be educated in medical schools at any time. Not because of any true free market forces. We are already faced by that rationing that's why we pay so much today and government had nothing to do with it.

That's like ignoring the fact that OPEC cuts production when prices fall, thus creating a market shortage.

Guilt caring? What about watching your elderly off loaded after three days? Do the hospitals and medical industry have no guilt? Morphine for COPD patients because they've used up there time?

[peterg76]

Those medical procedures are not exactly recreation.

[quidam56]

In Hannity's Amerika they seem to forget to check the facts they are disparaging, we already have rationed care and people are waiting in long lines to see a doctor. It's sad to see how they are stirring up a base who will need health care and will end up with the status quo if they get their way. Seems the Lewin Group is all the advise they need to source their desire to kill health care reform. In case you didn't know, the Lewin group is better know as UnitedHealthCare. The status quo is killing innocent people or causing them to loose their homes and lives to keep the politicians and profit machines filthy pockets full. If you live in Tennessee or Virginia, this is what is deemed, defended and supported as the acceptable standards of health care. It's all about greed. My father was begging for a gun, looking back, I wish I had granted him that wish.

http://www.wisecountyissues.com/?p=62

Where are the elected reps who campaigned with Obama and health care reform ? While the tea baggers are hollering the government is going to kill granny and all their ilk our congressman, senators and governors are silent and are well aware of the status quo.

It's frustrating !

[Katiebar]

The reason the congressmen and senators are silent is because now many have read the Bill that the House has written. Within it lies the seeds for the destruction of the Dem party, and any who support this Bill. Certainly, the Bill contradicts what Mr. Obama has been claiming in many areas, for example in the area of freedom to keep one's current healthcare program. This, as it reads on page 16 of the Bill, is not true in any real sense. So, the Dems are having a hard time refuting citizens who are more and more in tune with what is really going on.
For some reason, they are having a tough time explaining how you can cover 50 million new patients and actually save money. Or cover these new applicants with the same amount of doctors. Or keep doctors when you are going to dictate to them, and pay them less. Most have found it smarter to just remain silent. We'll see how long that can last.

[RonGallion]

Oh I forgot if this health care disaster passes they will take money out of Medicare to pay assist in paying for it. This plan in current form will cost more than 4 Trillion dollars. You could take 100% of the wealth of those making more than 10 million a year and would not come close to paying for that beast. So again the middle class will get screwed.

[RonGallion]

You are so wrong on so many levels. I live in Tennessee, I never have to wait in long lines to see a doctor.
Here are some facts for you.
PG 50 Section 152 in HC bill - HC will be provided to ALL non -US citizens,
Pg 22 of the HealthCare Bill MANDATES the Govt will audit books of ALL EMPLOYERS that self- insure.
Pg 29 lines 4-16 in the HC bill - YOUR HEALTHCARE IS RATIONED

[melodramy]

DUDE! Page 29 lines 4-16 caps the out of pocket expenses which may be charged to individuals and families as CO-PAYMENTS. Page 28 immediately above, exempts all preventive services from ANY cost-sharing - that's to encourage preventive services! Page 29 LIMITS cost sharing at an annual cap. They are talking about LIMITING COPAYS not rationing!

Sweet weepin jeebus, don't you know deductibles and copays exist in today's world, do you scream that that is "rationing" too?

Page 50 says "no discrimination" in coverage or service. It doesn't say anything about citizenship? Wtf are you so afraid of? We're ALL ALREADY paying for uninsured non-citizens - at very high EMERGENCY ROOM treatment rates.

By the way did you know US citizens can be treated in other countries at THAT country's public health rates and not at our own crazy US free-market rates? Should they be discriminating against us and denying us care when we fall ill on their soil, since we don't pay into their system?

You are the perfect example of "seeing what you want to see" and it is all coming out twisted and it is all coming from some deeply angry and bitter core that makes no sense to anyone but you.

[calfacon]

Well said Mr. Heath. Good doctors will speak to their patients about end-of-life issues, when it's appropriate. The Democratic plan will let them be paid for that. Hard tho to talk reason, truth and rationality with immoral liars.

[pdog]

Everyone seems to be missing the point. All this bill says is that medicare will pay for this procedure. Its is a new benefit of Obamacare. It is not a required that you do it either. Its is simple at matter of who pays that's it

[SusanStoHelit]

The conservatives aren't missing it - but they see an opportunity to twist the truth for political benefit.

[lauraj40026]

STudman thinks 8 year olds should be allowed to commit suicide.I am a do everthing kind of person so no one is going to save money wheather I sign the paper or not.

[PlaceboStudman]

Terminally ill 8 year olds who have less than 6 months to live, and those 6 months will be spent "living" in excruciating, agonizing pain from disease that can not be treated, yes.

It's called mercy.

[Neico]

What's mercy about seeing terminally illed 8 year olds or 85 year old in pain? Try compassion. I'm not advocating anything, but I don't see mercy to see people in pain that they have no control of.

The sad fact is that the healthcare insurer may deny coverage any time they feel like. To treat patients with cancer and other potential life threating diseases cost alot to make that person comfortable if the end nears.

What are you implying? Just curious.

[SusanStoHelit]

Then why are you afraid of this?

Knowing who is a "do everything" type of person, and who is a "if I lose this functionality, I no longer wish to live" person is essential to do the right thing for the person. The right thing for you, the right thing for the other people too.

[Glocksf21]

both parties use deception

[Neico]

OK, I get it that the Republicans lie and no one calls them out on it? The other senators that have some degree of facts should call them out like they did in the old western days. I'm not saying to have a physical altercation, but use the facts.

The article does not mention that if seniors are afraid because of healthcare reform, don't they know that medicare and medicaid will be gone by 2020(I may be stretching the timeframe)? Where are these seniors family members that can help them understand?

But a sad reality is that not many persons can not read or write, therefore, many will take what they hear politicians say and says it's the truth instead of researching for themselves. Seniors were young once so what happened to those skills to help them understand how things work?

I'm not a sour person but many seniors should stop listening to the politicians and start doing some work on their own to understand the process. If the seniors are still breathing, then they can also continue to educate themselves and not these politicians. If seniors are afraid of healthcare reform now then they will scared #$%^ when the Republicans back to power.

Everybody dies in the end and it's morbid to think about, but comes down to personal responsibility and have a plan for when that time comes.

[Kiri sute gomen]

I agree with you, although I believe the trouble you are referring to resides with trust. Many Americans rely on the trust they have with our representatives. Disproving there trust is difficult as most humans tend to hold onto there beliefs in the face of aversion. This is a tough situation to have when trying to move beyond serious issues.

Respectfully,

[SusanStoHelit]

Your mental abilities do decrease as you get older - simple statistical fact. As does your flexibility. Seniors aren't willfully failing to understand - they're working with what they've learned through life, who they've been accustomed to trusting, and dealing with the energy and skills they have - not to mention their priorities - they've got their own health problems, those of their loved ones, grandchildren, children, etc. They've got a life full of connections that are higher priority than doing their research, so they trust the people they've been accustomed to trusting.

[soupson52]

You folks obviously know nothing of AARP, a very politically active senior citizen organization.
Very intelligent group of seniors, may I add.

[Old and In the Way]

All of a sudden it seems lots of thirty-somethings are very, very interested in sparing me some expensive suffering. Its not hard to read between the lines.

[steamboat]

Amazing how they tie-in the person who is brain-dead (like a Terry Schiavo) with your everyday senior person......So in otherwords, somebody who is lets say 62 years old, a VietNam veteran, who has served and fought for his nation is expendable so that a 20 year old illegal immigrant is given preference­....Becaus­e thats what this jerk Heath is getting at..... And like you say these 30-somethings are the ones wanting this policy.....Hey, does that include Teddy Kennedy, Robert Byrd, Bill Clinton, Patrick Leahy and oh yeah, there own parents, also?

[ScreenName05]

Did you bother to read the article or did you copy this rant from some script? I am not a thirty something, I am exactly as you describe. Guess what I have a living will and so does my wife. I personally refuse to be resuscitated for any reason - because I refuse to bankrupt my family based on the current health care system. Maybe instead of ranting you should do a little real research, you might be surprised to find out how expensive your bad decisions can be.

[SusanStoHelit]

Nope. What we're saying is let everyone make their choice - we don't want to let you force the 62 year old veteran to live in agony the last days of his life, just because you'd like to deny care to the illegal.

Of course - illegals aren't eligible for the new insurance - but I doubt that fact means anything to you. Although the idea you'd allow someone to die in agony, rather than give them their own free choice, just to deny an illegal coverage - amazing.

[melodramy]

So go get a free consult with your doctor, and draft up your advance directives stating that no one under any circumstance should deny you any form of life-sustaining care, ever, no matter what state you are in or how much it costs, and that you grant no one power of attorney to make any such decision to the contrary should you ever be incapacitated.

Having done so, you will have just SECURED YOUR PERSONAL will in the matter.

[Terrance Heath - Huffpost Blogger]

Actually, I "tied-in" Terri Schiavo as an example, because she was a young woman who suffered an unexpected medical crisis, and did not have an advance directive. Thus the long dispute over what her wishes were, etc.

There are any number of people and families in the same situations every day, but I cited her case because no other received as much attention or became as widely known.

[Neico]

Old and In the Way--so you are saying that thirty-somethings are not in a position to understand seniors? Don't read between the lines but make sure you ask questions for yourself or research to get the facts.

You know Old and In the Way what's jacked up is when you die and when you have not planned your children or state will have to finish taking care of your business.

But thanks for calling me thirty-something and I like compliments! Keep them coming.

[Terrance Heath - Huffpost Blogger]

Actually, advance directives aren't just something seniors should have. I'm far from being a senior citizen, and I have one. Anyone is susceptible to illness or injury that leaves them unable to communicate.

That this measure was specific to Medicade is probably set some people off. But I would tell a 30-something that he needs to have an advance directive just as much as a 70, 80, or 90-something.

[SusanStoHelit]

Only giving you the choice. You don't even have to have the consult. You can go there, and say you want every single expensive treatment out there. But - if you DON'T want that - shouldn't you have a right to say so?

[Budokan]

RepubliKans hate America and they hate Americans. Their idea of health care is to crawl to the side of the road and disappear.

That's their ideology, founded entirely in hate, fear and ignorance. And that's why the political shiv needs to be applied to the GOOP once and for all in 2010.

http://kennethmarkhoover.com

[LURCHMONGER]

The fact that you say Republicans hate America and Americans is an ignorant statement in itself. What exactly would be the point of hating America when living in America? Also, what exactly does the K in RepubliKans mean? Since we're on the subject of assuming, what you are doing, I can only assume what it means, which (if I'm right) would completely discredit your argument and make you the real ignorant hater. I, unlike you, would rather not lump you into a group and slap a label on you, so I would like for you to explain please.

[calfacon]

Republican love only money and power.
People, middle class and/or poor are beneath their vision. Not so much that they hate them - they just won't let regular people get in the way of THEIR money and power.