Thursday, December 24, 2009

Alex Schadenberg Get All Riled Up Over an Ad.

A few days ago I posted about the ad campaign in Canada, where a huge brawl is taking place over the legalization of assisted suicide. The campaign is a series of plaque-like stickers on park benches with fictional stories about painful deaths. It is meant to bring awareness to how we die and it has garnered a lot of attention. It was created by two advertising executives who are trying to raise awareness for a series of end of life issue including aid in dying and living wills.

Now check out what Alex Schadenberg, the executive director of Canada's Euthanasia Prevention Coalition is ranting regarding the use of terms and their definitions regarding end of life care:

One of the promoters of this euthanasia campaign (under the title - Greywizard) accused me (in this blog) of trying to rewrite the english language. This person was insistent that he was right and I was wrong. The fact is that the Dignity in Death website that was developed by this person is wrong and irresponsibly misleading.

Greywizard also attempted to discredit me by calling me religious. Instead of dealing with the arguement Greywizard preferred to discredit me by accusing me of being religious. But euthanasia and assisted suicide are not religious issues but rather public safety issues.

Euthanasia is prosecuted under Section 222 of the Criminal Code (homicide) and Bill C-384, the bill that is being debated in parliament to legalize euthanasia and assisted suicide, would legalize euthanasia by amending section 222 of the criminal code.

The advertising specialists who are promoting the euthanasia campaign stated to the Toronto Star:
"We've both seen cases where passive euthanasia is the right thing to do."

Just because two advertising specialists want to call witholding or withdrawing life-sustaining medical treatment euthanasia, doesn't mean that it is euthanasia. This is irresponsible because it is often necessary to withdraw life-sustaining treatment to allow
natural death to occur. If good people who oppose euthanasia are falsely convinced that this action is euthanasia, they will refuse and create medical problems.

The issue of euthanasia is very serious. When someone directly and intentionally causes the death of another person, (euthanasia) for any reason, the person dies. This is an irrevocable decision.

To create false sympathy by using fictional stories is irresponsible. The ad campaign attempts to create a situation where people will believe that unless we legalize assisted suicide, people will suffer when they are dying.

It is not necessary to give physicians the right to directly and intentionally cause the death of their patients in order to prevent suffering. What we need to do is improve access and the availability to excellent care in Canada.

Advertising specialists need to maintain a level of ethics. The fact that these park bench stickers have fictional stories about a serious issue and they have website information that connects people to false and misleading information should be dealt with by advertising standards ethics.
As I stated in the Toronto Star article:
Alex Schadenberg, executive director of Canada's Euthanasia Prevention Coalition, agrees that the stories created by McKay and Manson "are very compelling" but calls their website "misleading and inaccurate.

"No one wants to see people suffering in the way they describe," but the pair confuse euthanasia, the debate on whether doctors should be able to actually take a life, with being able to request that a doctor withhold treatment so the disease takes its course, Schadenberg says.

In conclusion, it is interesting that the advertising specialists are now saying that they are promoting living wills. I guess a good technique of dealing with criticism is to change the issue. The advertising campaign doesn't actually promote living wills but rather it promotes euthanasia and assisted suicide.

Let's hope society will reject these advertising specialists for there false representation of a very serious and socially contentious issue.

Compassion at the end of life - and choice in how one dies - is a slippery subject to term and define for both opponents of aid in dying and proponents. Schadenberg prefers cut and dried ideas of death. A lethal prescription is in his mind - and essential to the purpose of his organization - distinctly different from, say, denial of treatment or removal from treatment. Or use of the double effect, as according to the Catholic church and doctors (to avoid prosecution) is really sedating a person to death in order to relieve pain. So long as the purpose is said to be relief of pain, the responsible party is not guilty of aid in dying.

See what I'm getting at? Ethics demark no clear line between alleviation of suffering and hastening death, or removing treatment, or denying treatment. What is best for the patient - as the patient decides - is what the doctor is there to do. And it should be what society is here to do.

The pending case in Connecticut will ask the courts to decide that aid in dying is not assisted suicide, a prosecutable offense, because the patient does it himself. Talk about out-defining the opponent!

Regarding the campaign, I imagine Schadenberg is bent because he has noticed how effective it has been. It is emotionally moving and demands a strong response to the suffering of patients.

The creators were wise to use fictional stories. Using the real name and situation of a patient would betray that individual's privacy. The use of fictitious characters really bothers Schadenberg though (and he strangely seems to equate fiction with "not serious") and I can understand why.

For decades, anti-aid in dying advocates have continued to betray a patient's privacy in end of life decisions. In fact, the entire premise of their fight is based on their assertion that they know what is best for a dying patient than the patient or his doctor do. Yes, these groups will claim that they are working for the individual's best interests, but when that means asserting rights over another's health care decisions, it's a false claim.

I really suspect Schadenberg's just sorry that he's not the big voice in the media getting to frame the issue, as he typically tries to be.

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Not a Dime of My Tax Dollars for That Brand Name Drug!

Dr. Scott Gottlieb has rallied the "America has the best health care in the world" crowd with his pro-doctor, pro-medical industry op-ed in today's WSJ.

Let me just say up front that it's hard to find something good in this health care bill already without making up poorly-framed arguments that those poor doctors and suffering medical corporations are going to have to, you know, adjust their practices. Had the industry better regulated itself over the past few decades, we wouldn't be where we are now. In a predicament where health care coverage is tapping the country's economy and still not reaching the majority of citizens effectively.

Of course the Wall Street Journal has a particular clientele, one that belongs to a class of society pampered by employer-paid stellar health care coverage. To claim that our system is currently working is to ignore the 45,000 deaths a year from inadequate health care access, or the 50 million Americans who have no health care at the moment. But this demographic never saw health care as a right, only as a commodity. If those poor bastards in a Texas had studies harder, pulled themselves up by their boot straps, they'd have decent jobs and decent health care coverage. In other words, not having health care is shameful and indicative of laziness. So goes the privileged reasoning.

Gottlieb makes the following claims in his piece:

While the AMA supports health care reform (and it's a dogged piece of legislation that has little to do with reform and all to do with appeasing the medical industry), various surgeon and specialty associations oppose it. That's because they will be hard pressed to pursue their specialties with the same abandon if they hope to accept Medicare payments. The legislation reigns in specialists - a group that has ballooned over the past few decades simply because the AMA has encouraged licensing of such specialists and because that's where the money is.

He protests the new powers given to Medicare and Medicaid to select cheaper services for patients, refusing to pay for name-brand drugs and treatments when generic will do. Of course the medical industry is up in arms over this. The overhead on name-brand services is what has made the industry such a rich and powerful loggerhead in medicine. Basic economics shows that Medicare and Medicaid can't afford - and shouldn't pay for - such overpriced services when cheaper ones are available.

Gottlieb argues that those who want to sue Medicare for not covering less expensive services will be discouraged from suing for them. To this I say: If you want a specialty services, pay for it. As women are being forced to do with the "specialty" service of abortion. For women the law of no coverage is simply religious discrimination but once mention that making economic decisions regarding other coverage is unfair and you get a gaggle of "free-market" conservatives claiming that Medicare has too much power. Let the patient pay for their extraordinary care if they think it will better help them. This isn't rationing. This is practicality in buying as far as I am concerned.

Gottlieb also criticizes what he calls incentives for independent specialists to merge or consolidate with other practitioners in order to keep costs down in delivery. This too is a practical concern. Independent specialists cost more, their overhead is not shared with other practitioners and therefor must come from somewhere. Until now that has been from Medicare and Medicaid or high-end insurance companies willing to pay more when the employer or patient pays more. If we want to cover all citizens and apply government regulation to government plans to reign in costs, we have to address the excesses. But if I were an independent specialist, I would be squealing too. My fat run is coming to an end.

Most of the cost-saving programs Gottlieb is criticizing are really demonstration programs, trials by Medicare to see what works. Instead of addressing the excessive costs of health care today, he is focusing on the wrong audience, the doctors, privileging their position - as all associations are of course apt to do - above that of the patient. But that's because Gottlieb is opposed to treating medicine as a right, affordable and accessible. Instead he wishes it to remain a commodity that has led to overspending.

He writes:

Regulation of medicine has always been a local endeavor, and it's mostly the province of medical journals and professional medical societies to set clinical standards. This is for good reason. Medical practice evolves more quickly than even the underlying technologies that doctors use. This is especially true in surgery, where advances flow from experimentation by good doctors to try different surgical approaches.

Sorry, but industry self-regulation is not regulation. As the medical industry has proven over the past decades, the great percentage of killers in the US have gone unaddressed by the big money innovators. Equipment and drug manufacturers have both pressured the public into pursuing boutique illnesses while heart disease and cancers have proven to go unchecked. That advancing innovation comes from small-time, independent surgeons is a fallacy. Innovation now, as Gottlieb calls it, is large corporations finding niches that will make them quick money.

The rallying cry worked for abortion has been "Not my tax dollars!"; how about using it to curtail excessive drug company profits and "innovations" in medicine that only address boutique treatments? When we start seeing advancements that change lives for those suffering the primary killers, preventative medicine that reduces costs and increase quality of life, and more affordable prices for all Americans, we can then discuss the excessive ways of the medical industry as innovative.

Gottlieb, a fellow at the notoriously conservative Free Enterprise Institute is approaching medicine from the medical industry's position. We've unsuccessfully tried that for decades. It's time we approach medicine from the standpoint of the patient.

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