Tuesday, November 10, 2009

Still Crazy Over End of Life Care, After All These Years.

One of the most impressive lines of misinformation out there regarding health care is that talking to a dying patient about end of life choices is the same as promoting euthanasia. Outlandish? Yes. Motivational to "pro-life" groups. Hell yes.

The crazy claim requires some crazier reinforcement: we must protect our elderly and most vulnerable from "death panels" and the "culture of death." Just as "pro-life" groups claim that women are addicted to abortion - as if anyone in their right mind who has had an abortion could be? - they parlay compassion in dying into a cult-like worship of death. It serves their purposes but how does it help the elderly and terminal?

Christopher Weaver at Kaiser Health News notes that while the noise this summer over "death panels" was deafening (and misinformed), it wasn't the first time the public got bent out of shape about end of life planning:

It was early summer. A senior federal health official wrote a memo suggesting that living wills -- documents that can convey patients' wishes about when to end life support -- could help curb health-care costs.

The memo leaked to the media. By August, a New York Times' column said the official "likes euthanasia."

Sound like this year's angry August? Well, this story unfolded in 1977, and the official in question was Robert Derzon, the first administrator of the Health Care Financing Administration, now the Centers for Medicare and Medicaid Services.

Derzon's memo said, "The cost-savings from a nationwide push toward 'Living Wills' is likely to be enormous" -- a suggestion echoed in current Democratic proposals to pay doctors for counseling patients about end-of-life care. But, it also warned of "some negative public reaction." (Read the full memo here.)

In an August 14, 1977, column, a Times writer called the note an "amazing disclosure of the extent to which some in the Government would go to reduce medical costs."

But that's not exactly what Derzon, who died in June from swine flu, had in mind.

At his recent memorial service,
Clifton Gaus, an associate administrator at HCFA and co-author of the controversial memo, explained. "The hysteria, misinformation and accusations were vicious and lasted for weeks," Gaus recalled at the memorial service. "What is more surprising is that this country has made big strides in [patients'] rights to living wills and in making death more comfortable," he said. "Yet the fringe critics still are able to command huge media attention."

Former New York Lieutenant Governor and health-care firebrand Betsy McCaughey leveled
similar accusations about death panels and current White House adviser Ezekiel Emanuel, who has written about end-of-life care, in the New York Post this summer. Former Alaska Gov. Sarah Palin modernized the hysteria over end-of-life care when she popularized the term death panel" in an August Facebook post.

The claims went viral in August town halls around the country, but were quickly debunked by news reports, including in the New York Times, which
called the rumor "false" in a headline.

But, back in the '70s, "The New York Times did exactly what the crazies have done years later," Gaus said in an interview. Gaus, who also shared his eulogy notes with us, added that he brought up the unfortunate chapter in his boss's career in order to set the record straight. "It's chillingly parallel" to today's debate, he said.

The House Democrat's health care bill -- which passed Saturday -- preserved the provision to pay for end-of-life counseling, with some extra caveats emphasizing that the counseling is voluntary and not meant to "encourage the promotion of suicide or assisted suicide." The Senate Finance Committee scrapped it altogether after complaints by leading Republicans and August protests.

Labels: , , ,


Post a Comment

Subscribe to Post Comments [Atom]

<< Home