Today, Forbes.com published an article by David Whelan entitled “ObamaCare Dives Into End-Of-Life Debate.”
Lead sentence:
Buried halfway through the current version of “America’s Affordable Health Choices Act,” the House version of ObamaCare, is a set of proposals pertaining to end-of-life care.
What follows is a pretty balanced and nonhysterical look at what is in the bill and what people are saying about it. The whole article is worth reading, but I want to share the closing paragraphs, devoted to comments from Marilyn Golden of DREDF and Diane Coleman of NDY:
Still, some activist groups that are not necessarily opposed to ObamaCare are concerned about the end-of-life proposals in the bill. Marilyn Golden, of the Disability Rights Education and Defense Fund in Berkeley, Calif., has been active in opposing physician-assisted suicide at the state level. Many disabled people worry legalizing suicide would lead to euthanasia.
Golden points out that many doctors, when counseling patients, push for do-not-resuscitate orders or have them sign boilerplate documents that can lead to the premature denial of lifesaving medical care. “I don’t want to say we’re opposed to the language in the bill,” she says. “But there are legitimate concerns about how advanced directives are administered.”
“There is reason to be concerned,” says Diane Coleman, of Not Dead Yet, a group in Rochester, N.Y., that opposes physician-assisted suicide and what it calls medical killing. “The disability community,” she says, “often experiences pressure to sign treatment-withholding orders.”
She cites a case of a woman who works in her building who became a quadriplegic 11 years ago. Her physicians encouraged her family to remove life support while she was on a ventilator for five months, even though she was improving and eventually recovered to the point where she could live independently with a wheelchair.
Those concerned about unwittingly getting the plug pulled are advised to make it very clear to all their medical providers that they do not have a “DNR,” and that if they stop breathing or their heart stops they want to be revived.
“Society does devalue older and disabled people,” Coleman says. “And the medical profession is not always very accountable.”
There is a “comments” section for the article, so please check out the whole article and leave a comment. –Stephen Drake
I would actually imagine that the language here could be good for the disability community, since it will give doctors more of an incentive to actually sit down with patients and discuss what they want, instead of just shoving a DNR at them and saying “here, sign this.”
I’ve done directives to physicians for people and it is really common for them to say “I don’t want to be put on machines/feeding tubes” automatically without actually thinking about which circumstances they’re talking about – they seem to think DNRs only apply to cases in which they’re “vegetables” or highly unlikely to regain consciousness, or when they’re terminal and in a lot of pain. Give people the opportunity to actually sit down and talk about it, and you’re likely to get better considered, less coerced results.
Of course, it’d be much better if they paid for a consultation with someone other than a (potentially interested) medical professional.
sam,
there’s no way of knowing if it will be good or bad. That’s part of the problem, especially since the real goal of this is to reduce medical costs (and risk of litigation) – with respect for autonomy being a secondary benefit. Read enough of the literature touting advance directives and the primary goals come through pretty clearly.
As to going to other professionals, like maybe lawyers…
I’ve already run into people who specifically went to a lawyer and were given a basic – and badly badly worded – boilerplate document to check off in most places. No real help there, I’m afraid. –Stephen
I was unable to work the signup system for Forbes, in order to comment, at the article.
It is tempting to list famous people
as examples of end-of-life care:
Ronald Regan, for one. And throw their names into the discussion.
I think the discussion, as is,
focuses on the unfamous, regular folks without money.
Want to save money, Obama
Administration (and the candidate
got my vote once, probably not again)? If the US military gets out of the war(s) and occupations, lots of billions available. Another way, scaling down the military: reduce the 100plus bases
(or many more hundreds, depending on how the real estate is counted)
all over the world. De-empire shrinking saves money, saves lives.
Soldiers, civilians…
It almost makes me wonder if there is some kind of disconnect:
the bailout billions to trillions to banks — n o t much in question, but health care costs?
Oooooohhhhhh,no! Single payer changes the whole discussion. But it’s not discussed.
How can we change the discussion? There’s money, but where is it OK to spend it, according to Forbes? Not where it’s OK to spend it according to most Americans, via polls.
Brava, Diane Coleman and Marilyn Golden.