How GOP fear mongers have perverted “living wills” into euthanasia for Grandma

Posted by AzBlueMeanie:

NEVER underestimate the depths to which Republicans will sink in employing their time-tested fear mongering to win at all costs. The PR firms which do their dirty work are bottom feeding sewer dwellers. (I have met many of them over the years). Frightening the elderly with death is as low as they can go.

Rachel Maddow follows up on my previous post about this GOP Astroturf campaign. Maddow addresses specifically the "living will" being perverted into "Obama death panels" by moon-bat in chief Sarah Palin and a plan to euthanize Grandma by conservative talk radio and Faux News, and even Republican members of Congress. (at 3:35 of the video)

A "living will" is a durable power of attorney authorizing advance health care directives. You get to direct how the attorney-in-fact that you designate is to carry out health care decisions in accordance with your advance directives in the event that you are unable to make or communicate your decisions due to incapacity. Your attorney-in-fact is bound by your advance health care directives. "Living wills" are provided for by statute in Arizona.

I have drafted living wills for many clients over the years. There is nothing controversial about living wills — everyone should have one. Without a living will, it is the hospital, doctors, and insurance company risk managers who will decide for you. This is critical to some individuals who want to direct a "do not resuscitate" order (provided for by Arizona statute). If that is your wish, you must comply with the statute. Otherwise, medical providers may keep you alive in a non-responsive state indefinitely. Think Terry Schiavo.

The living will provision that the right-wing fear mongers have perverted into "euthanasia for Grandma" is actually a bill sponsored by Republican Senators Johnny Isakson (Ga) and Susan Collins (ME). It provides that medical providers will be reimbursed for their time in discussing living will and advance medical directives with you (currently, medical providers have an ethical obligation to discuss this with you at your initiative, but Medicare does not reimburse them for their time).

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In 1990, Congress required health-care institutions (not individual doctors) to give new patients written notice of their rights to make living wills and advance directives — but also required them to treat patients regardless of whether they have such documents.

The 1997 ban on assisted-suicide support specifically allowed doctors to honor advance directives. And last year, Congress told doctors to offer a brief chat on end-of-life documents to consenting patients during their initial "Welcome to Medicare" physical exam. That mandate took effect this year.

Section 1233 of the America's Affordable Health Choices Act of 2009 would pay doctors to give Medicare patients end-of-life counseling every five years — or sooner if the patient gets a terminal diagnosis.

Right-wing fear mongers have portrayed this as a plan to force everyone over 65 to sign his or her own death warrant. That's total bullshit. As noted above, Federal law already bars Medicare from paying for services "the purpose of which is to cause, or assist in causing," suicide, euthanasia or mercy killing. Nothing in Section 1233 would change that.

The objection from some on the right is that this is not purely voluntary, that the doctor may now initiate the discussion, and the doctor will now have a financial incentive "to pressure" patients into a living will and advanced medical directives. They also object that Section 1233 dictates the content of the consultation. Charles Lane – House Health-Care Reform Bill Oversteps on End-of-Life Issues I find these objections overstated and not realistic.

As an attorney, I have had this discussion with many clients after advising them to first consult their physician. My clients have been very definite about what they want. There have been other occasions when family members have had a conflict with the hospital and its insurance risk manager over end of life care that family members have argued was not in accordance with the wishes of their loved one, but because the patient did not have a living will and advanced medical directives the family was at the mercy of the hospital and its insurance risk manager, forcing them to hire an attorney and go to court. You and your family members do not want to be in this highly charged emotional situation for end of life decisions. Discuss this with your physician and then go see your atttorney for a living will.


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5 thoughts on “How GOP fear mongers have perverted “living wills” into euthanasia for Grandma”

  1. Clipper:

    I’m not sure why, since Palin was spreading lies, but those sections were removed from the HB 3200.

    So, it’s kind of a moot point now.

  2. What are the bill numbers of the amendments proposed by Snowe and Isakson to the House Bill? Can you provide a link?

  3. I have had a living will since 1995. To put it succinctly, I don’t want to be thrown away – neither do I want to be subjected to all kinds of medical stuff. We all die – I want to do it with my dignity intact – and most important, I want to make the decision so no one needs to try to figure out what did I REALLY want – they know what I REALLY want!

    I take serious exception to the statements of Sarah Palin that Obama would kill her Down Syndrome child. Sarah Palin was inciting audiences to violence during the campaign and I could never figure out why someone – some decent, self-respecting Republican, to be exact, didn’t call her on it. People who incite to violence are irresponsible and are undermining everyone’s right to free speech. The definition I learned of free speech is that it stops when someone yells fire in a crowded theater. I think we should add inciting to violence to that definition.

  4. There is nothing about rationing health care in the bills in congress. As for panels deciding who gets a transplant, they already do that. People are placed on a list, and it isn’t a ‘first come, first served’ deal. They review your health and how critical your need is. If you have a greater need and have a high probability of surviving the procedure, you get to the top of the list. If you have serious health issues that make it highly unlikely that you will NOT survive such a major operation or you have other serious health issues, you get moved down or even off the list. I’ve see this firsthand:
    in 2005 my cousin’s daughter was suffering from severe liver failure due to the chemo she had received during years of treatment for leukemia. Haley was 9 at the time and had battled the disease on and off since she was 2. I don’t remember if the UofA hospital where she had been a patient for far too much of her life either rejected her for a possible transplant or if they just didn’t do pediatric liver transplants. Either way, in August 05 She was flown to San Diego to be tested as a possible candidate for a liver transplant. The facility there decided she was clearly in need of the transplant but felt that the leukemia had not been in remission long enough. they contacted other hospitals to see if they would put her on the list, all turned them down without even seeing Haley. Eventually a hospital in Nebraska agreed to see her for an evaluation. Sadly, a few days after that, the leukemia returned. Haley herself made the final decision to not pursue further treatment and she died 4 days later.

    As much as it pained us all to lose Haley, it became evident that the decision to not put her on the list may have been the right call.

  5. The new thing is to use some articles Ezekiel Emanuel (Rahm’s brother and a Obama health care advisor) has (co)authored which are being taken out of context to suggest that there will be ‘death panels’ that decide who gets medical treatment. In particular is a quote from an article in a recent edition of the Medical Journal the Lancet.

    I have read the article and it is about under what ethical system should a scarce medical resource like transplantable organs or limited number of vaccines be allocated. They review a number of utilized and proposed ways to make these decisions and propose one that mixes the decision based on prognosis, what will save the most lives, the use of a lottery system, instrumental value, and the age of the life expectancy of the person weighted to those in adolescence or early adulthood.

    It shows the level of dishonesty and ignorance going on that a discussion about how to prioritize organ transplants gets turned into claims that the health care bills contain provisions for ‘death panels.’

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