Wednesday, December 23, 2009

The Catholic Health Care Juggernaut.

Barbara Coombs Lee is a tough lady! She's been the loudest, clearest voice to call out against the new US Conference of Catholic Bishop's latest revision of the Ethical and Religious Directives that govern medical care delivery at more than 620 Catholic hospitals in the US.

The new guideline, instituted last month, determines that artificial nutrition and hydration (ANH, delivery of food and water via surgically applied feeding tubes) is "obligatory" care.

The USCCB has reached into an area of settled law in the US - it is now legal for patients or their proxies to deny ANH in all 50 states) - and created a scenario where patients lose autonomy over their own care.

Coombs Lee has written a number of articles about the new directive and now ultra conservative LifeSiteNews is of course eviscerating Coombs Lee for her advocacy for patients' rights. They think they have an easy target in Coombs Lee because she is the president of the largest aid in dying advocacy group in the US, Compassion & Choices. C&C was formerly called the Hemlock Society - run screaming euthanasia with your hands in the air - the great bogey-organization out to kill your granny and every disabled person in the country.

It's all demonization, of course. "With us or against us" stuff from the Religious Right, hellbent on painting all those who have nuanced views of the necessarily nuanced delivery of health care as the "culture of death." The hallmark of the "pro-life" movement has been to parade a simple message, say "sanctity of life," until even the mainstream is apologetic for it's position on even the most common procedures like abortion.

The Religious Right has succeeded in shaming women who decide the number of children they have. With end of life care, they too are using fear of death and the ever-loaded term euthanasia to cow the public into looking away from the suffering that their draconian policies impose. Preying on marginalized and vulnerable members of society is their schtick. And they're good at manipulating not only public opinion but legislation - as we've seen with the Stupak Amendment, written and approved by the USCCB, in the health care bill.

Supporters of the new policy are toeing the Catholic Right line on prolonging death and coming between a doctor and their patient.

All this would matter little if the Catholic Church didn't deliver medical care to 20% of US patients, protected in any decision they make regarding patients' rights and health care choice by ever-increasing provider refusal laws. These health care entities are in all 50 states, and though subject to state laws in some case (regarding, for instance, emergency contraception) these laws are often unenforced.

The directives most often make women, gays, and elders targets of discrimination by any medical personnel who hold prejudice against certain lifestyles. But the greatest damages are done when institutions, like the Catholic health care juggernaut, claim conscience protections.

Moreover, patients who assume that hospitals offer a full range of medical care find themselves in hospitals where doctors are forbidden to offer referrals for services or even inform patients of medical care options. This type of continued discrimination by the second largest provider of health care in the US is made possible by tax-exempt status granted by the federal government and 50% of institutional funding from Medicare and Medicaid dollars. And abetted by a medical industry that strongly opposes shifting health care from a commodity to a human right.

All the noise about preventing federal tax dollars to pay for abortion has silenced awareness of the fact that already federal tax dollars are spent to enforce discriminatory delivery of medical care to one in five patients in this country.

From LifeSiteNews:

One leading national euthanasia advocate has attacked the U.S. Bishops' revision of bioethics rules to protect cognitively disabled individuals from being starved and dehydrated to death.

Barbara Coombs Lee, the president of Compassion & Choices (formerly the Hemlock Society) condemned the new directives in a Huffington Post column December 17, claiming that the revision amounted to a violation of patients' right to choose how to die.

"Compassion & Choices understands what this will mean for your healthcare choices. And the impact of the decision is greater than you can imagine," wrote Lee, who pointed out the broad scope of impact the bishops' directives had on medical services across the country - much of which is Catholic.

The new directive, issued earlier this month with little media coverage, states that, “In principle, there is an obligation to provide patients with food and water, including medically assisted nutrition and hydration for those who cannot take food orally.”

It continues that the obligation “extends to patients in chronic and presumably irreversible conditions (e.g., the 'persistent vegetative state') who can reasonably be expected to live indefinitely if given such care.” It also clarifies that “medically assisted nutrition” becomes “morally optional” when it “cannot reasonably be expected to prolong life,” or when it would cause excessive suffering.

The new directive follows Church teaching as clarified recently in Pope John Paul II’s 2004 Address on Life-sustaining Treatments and the Vegetative State: Scientific Advances and Ethical Dilemmas, as well as the 2007 statement of by the Congregation for the Doctrine of the Faith, Responses to Certain Questions of the USCCB concerning Artificial Nutrition and Hydration.

Lee said that the revised directive "fails to respect settled law that empowers patients with the right to refuse or direct the withdrawal of life prolonging care, including artificial nutrition and hydration."

"The Supreme Court in the case of Nancy Cruzan recognized that such a choice is a fundamental liberty guaranteed by the US Constitution," she argued. "State courts have reached the same conclusion based on State constitutional law and common law. But the Bishops have demonstrated no interest in patient choices that conflict with their Directives."

The National Catholic Bioethics Center (NCBC), however, pointed out that the directive reemphasized the long-standing view that patients are entitled to food and water as a natural means of preserving life, which is not essentially considered a medical intervention to preserve life - even if a medical procedure is needed to put in place a feeding tube.

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