Wednesday, December 2, 2009

The Benefits of Hospice.

As I prepare to begin my own hospice training and volunteering, I read Jane Brody's column with curiosity and sober preparation. I saw her speak at the Compassion & Choices conference in DC in October. She was wise and lovely. You can find the entire article here. Here's a clip:

Hospice workers never know what they may find when they enter the homes of people whose doctors expect them to die within six months. But they are prepared to handle almost anything and have a team of specialists to call upon when needed: doctor, nurse, social worker, spiritual care counselor, bereavement counselor. The home hospice service is but a phone call away 24 hours a day, 7 days a week. The needs of patients and families are met within hours, if not sooner; moreover, the cost is usually covered by Medicare or Medicaid.

With hospice, death assumes a more natural trajectory, unencumbered by frightening machines and sometimes grotesque interventions of modern medicine that do little, if anything, to prolong life and often make dying more painful for patients and families, as well as costlier for society.

Indeed, studies have shown that, all other things being equal, patients receiving the comfort care provided by hospice tend to live longer and die more peacefully than those who continue to get intensive care for their disease when treatment has ceased to help.


Suffering Is A Gift From God.

From Reflections of a Paralytic:

This is an excellent article from Steve Pokorny at Catholic Exchange. A bit of an intro:

Throughout human history, since Adam and Eve, there has been the temptation to want to take the powers of life into our own hands. There is the insidious idea that is floated through our fallible minds that if we manipulate things to our liking, then things will just go better. Or so we think.

Take the issue of euthanasia that is ramping up its exposure. From a recent Discovery Institute article entitled “Suicide Radicalism Surges in America,” we read that “Doctor” Philip Nischke of Australia “has brought his suicide seminar to California and Washington State, where he taught all comers how they can make themselves dead.” His logic (albeit misguided) leads him to “if we each own our bodies, he says, and if self-termination is an acceptable answer to human suffering, then assisted suicide shouldn’t be restricted to limited “subgroups” such as the terminally ill.”

“Dr. Phil” would be correct if our bodies were merely an instrument, something that is separate from ourselves. Yet this is the same trouble that dear fellow Descartes got himself into.

I don’t want to give too much away here – read the whole thing!

When we suffer, we work to find reasons why. Simply saying that life is suffering is not enough. The fear of death and pain demand that we find reason, justification. If we decide that we are not responsible for our lives, we can pass the responsibility to God. It's easy. He won't give you more than you can handle. You must learn from your pain. Suffering is God's punishment for your sins (as was Christ's) and your blessing.

Yet, not everyone believes this. Our society is pluralistic, of many races, genders, sexualities, income brackets, faiths, and ideas. Assigning our laws to reflect only one of these is discrimination against all others. If democracy can only exist when church and state are separate, the above advocates for a theocracy. And we all know how theocracies work out, right?

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Demonizing the Advocates for Patients' Rights.

Wesley J. Smith writes today that those wicked people at Compassion & Choice are, you know, out to kill us all with their "elastic" definitions! They must be members of the "culture of death!" You know, the blood hungry, ready for a killing campaign, bound to come after you, your grandma, your organs and every other member of society. (Yup, those abortion advocates are in the culture of death too, determined to kill all the babies in the world! They love abortion and killing, yup!)

Be very afraid! And please, sacrifice your autonomy, dignity, human rights, faith, personal freedoms, liberty and suffering up to God. And not any old God. Wesley J. Smith's, of course. He'll be the judge of when you die and why.

The assisted suicide ideologues at Compassion and Choices–formerly the Hemlock Society–pretend that their agenda is very limited and constrained, merely a teensy-weensy safety valve for use when nothing else can be done to relieve suffering. That’s all phony, baloney of course. The ultimate agenda is expansive, well beyond the actively dying.

Proof of this is found in answers to interrogatories C & C filed in connection with its Montana lawsuit, that asked its definition of a “terminally ill adult patient,” who the complaint claimed had a state constitutional right to assisted suicide. Usually, as in Oregon, this means 6 months or less to live regardless of the medical treatment available to the patient. But C & C’s definition for Montana turns that more precise definition on its head. From its interrogatory answer # 4 (no link, my emphasis):

The term “terminally ill adult patient,” as used in the complaint, means a person 18 years of age or older who has an incurable and irreversible condition that, without the administration of life-sustaining treatment, will in the opinion of his or her attending physician, result in death within a relative short time. The definition is not limited to any specific set of illnesses, conditions or diseases…

In other words, the patient won’t die even if he or she receives life sustaining or curative care, but if no such care is rendered.

That’s a very elastic definition. Think about it: If a 20-year-old diabetic refuses insulin, he will die within “a relatively short time,” but if he takes insulin, could live for decades, a full life span. Ditto, AIDS patients taking the viral inhibitors, cancer patients receiving chemotherapy, patients on kidney dialysis, perhaps even psychiatric patients who are not suicidal only because of anti depressants, etc.

Also, get their description of “intolerable dying process,” for which assisted suicide is the supposed remedy:

This is a subjective determination made by the individual patient based upon his or her medical condition, and circumstances, symptoms, and personal values and beliefs.

In other words, it is whatever a patient says it is at the time he/she wants to commit suicide. Such looseness over who qualifies makes impossible any meaningful controls over assisted suicide–which of course is the point.

C & C are very cagy. But in Montana, they have shown more of their true colors, for example, disdaining the kind of “protective guidelines” put into Oregon and Washington law. So be very clear, the assisted suicide agenda is not narrow. It is very broad. Activists here–unlike their counterparts overseas–just generally lack the candor that would permit us to have a true debate about the means and ends of the ultimate assisted suicide/euthanasia agenda.

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Huckabee Works to Unify "Pro-Life" Advocates on All Discriminatory Patients' Rights Abuses.

From the infamous LifeNews:

Former Republican presidential candidate and Arkansas governor Mike Huckabee spoke to 700 people at the annual Tippecanoe County Right to Life banquet Tuesday night. He urged the pro-life advocates in attendance to be consistent in advocating the pro-life position.

Huckabee said that, for him, holding a pro-life view means more than opposing abortion -- it extends throughout life to issues such as assisted suicide or euthanasia.

Or, as the potential 2012 presidential candidate said, “from the womb to the tomb.”

“For me, it’s not a political issue, it’s a matter of principle,” he said. “Some people try to make it an issue of abortion, but it’s really about every human life having value, dignity and intrinsic worth."

“People say I'm anti-abortion," Huckabee added, according to the Purdue Exponent. "That does not describe me actively, accurately or efficiently. I'm not anti- anything. I am for treating people as I'd like to be treated."

Huckabee struck a chord often mentioned by pro-life advocates in noting how the devaluing of some human lives -- such as those of unborn children -- results in lessening the value of others -- like the elderly or disabled.

“This is why every person must get involved – you have to stand up and speak up or this is what can happen,” he said. “Once a culture begins to devalue human life, it begins to deteriorate.”

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What About Separation of Church and State?

Carole Joffe has a great post up at RHRealityCheck about the assertion of Catholic and evangelical groups that they have a justified role in delivery of social services. Her piece gets to the heart of the issue I've been ranting about for days: that these groups wish to continue the imposition of their ideological values while maintaining tax exempt status and receiving federal funding. Their argument is that they do so much for the nation that they can't possibly be ordered to comply with patients' rights. Joffe writes:

Most fundamentally, however, the Church’s recent political activism on both gay marriage and abortion raises disturbing issues about the current state of play regarding church/state separation in the United States. The U.S. is neither a “Christian nation” as fundamentalists like Pat Robertson have long-declared it to be, nor one where its citizenry should be ruled by Catholic teachings, as the Bishops appear intent on achieving. But evangelical Protestants have long been tied to the Republican party. With Democrats in power, the Catholic Church is inevitably more influential at this moment, given its historical support of many of the issues favored by Democrats (with abortion being a glaring exception). As if the coming deliberations in the weeks and months ahead over health care reform were not complicated enough, these negotiations also challenge the Democratic Party to reaffirm a strong commitment to church/state separation.

It's a great little reminder of how the Catholic Church is working to assert the myth that theirs is the moral position; that they do more charity work and more for the poor than anyone else. There's no ground for this when you're talking social services, particularly hospital care. Allowing them the moral argument gives them more credibility than they deserve and only enforces their continued encroachment on patients' rights.

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Center for Reproductive Rights on Conscience Protections in Health Care Reform.

There are three main reasons that the conscience clause contained in section 1303 of the Senate healthcare reform bill – and not the conscience clauses in the House of Representatives’ version of the bill – should be included in the final bill:

First, the Senate bill puts women’s right to healthcare first without compromising conscience rights, while the House bill puts anti-choice ideology ahead of health.

Second, the Senate bill respects, and treats fairly, all viewpoints on abortion, but the House bill version would allow people to be discriminated against based on their viewpoint.

Third, the Senate bill is better because it provides more comprehensive protection for conscience rights than the House bill.

For more explanation of each point, go here.

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Center for American Progress Carries Water for USCCB?

A new fact sheet from the Center for American Progress puts a pretty face on Catholic provider refusals and involvement in health care delivery and reform. Called, "The Moral Dimensions of Health Care Reform: How Legislation Measures Up to Catholic Social Teachings," the article praises the church's participation in health care (a touting of influence that I have seen again and again the past few weeks since the USCCB noise over abortion) and perpetuates the idea that the Church is committed to social issues.

The introduction states, in part:

The Catholic Church is also a key player in health care delivery. In fact, it is the largest provider of nongovernmental health care in the United States. The Catholic Health Association’s vision statement notes it aims to be “a vibrant presence in enhancing the health of communities and access to quality care for everyone, with special attention to those who are underserved and most vulnerable.” The Catholic Bishops have observed that this involvement in the health care system illuminates the strains and stresses related to inadequate health care and the human consequences of a failing system.

Much of the recent debate over health reform has focused on abortion funding and coverage. While both bills in Congress take steps to address the concerns of those who have a religious or moral objection to abortion—in particular the objections of the Catholic Church—it is helpful to consider the many other criteria presented by the Church for ethical health reform that the bills satisfy. It is also helpful to note that abortion is not the only legislative provision under debate. The Church also stresses the importance of universal coverage for everyone in the United States—including undocumented immigrants—which neither bill fulfills.

This fact sheet lays out in detail how the health care bills now under consideration in the House of Representatives and the Senate reflect the criteria laid out by the U.S. Conference of Catholic Bishops as important to health care reform. The criteria were taken from anofficial statement submitted by the USCCB to the Congressional Record on May 20, 2009.

In other words, the report has no nitty-gritty in it. Check out the sections on "respect for life" and "pluralism." While I commend the Church's support for health care reform (why we all wouldn't support insuring every citizen, I don't know), I can't tell if this is progressives buying the myth that Catholic health care networks and hospitals do more for the poor than others (thus bolstering the church's influence on reform), or as Sarah Posner wrote this morning, was something written by the USCCB.

It looks to me like the barrel the Catholic church has been framing their participation in health care to place us over. This argument claims a number of untruths:

* the Catholic health entities do more for the poor than other hospitals (untrue, studies show they do the same or less than other non-profit hospitals; service of the uninsured at hospitals is a law; Church or Catholic donations make up the smallest percent of funding at these entities; the US government, through state and federal funding of Medicare and Medicaid cover 50% of their budgets.)

*Catholic hospitals support plurality of delivery (if this were true, they would better inform patients entering Catholic hospitals and health care facilities about the services they don't provide, and offer referrals to patients who disagree with their ERDs and seek services outside of what these hospitals provide.)

*by touting their size, Catholic entities are working to make citizens and the government make the either/or decisions we saw with the house health care bill: either let us operate the way we want to -denying routine services like tubal ligations, sterilizations, counseling on STD and AIDs prevention, denial of advance directives, and abortion services - or you cripple the largest provider of health care in the US. It's an argument for continued discrimination. There's nothing moral, pluralistic, or compassionate about it.

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