Can't they even leave me alone when I'm dying?

While we are all going to die, each death is an enormously personal thing. I've been through the process with a lot of people, and it is never, ever easy.

My reaction to the talk about government-mandated death panels (which Joe Klein thinks are a great idea) is that I can't believe things have reached the point where the matter is even under discussion.

If the government can't at least leave us alone in this most personal matter, then where will it ever leave us alone? For me to say that when I die, I would like to do it without the help of government bureaucrats is an extreme understatement. In fact, a government-mandated panel is the last thing in the world I want near me when I die!

The idea is enough to make me wretch.

Bear in mind that I'm a far cry from the enforcers of life at any cost, who would struggle to pray over me and stuff me with tubes even though I wanted to die. I have been intimately involved with end of life decisions, more than I can count or remember. At no point was it considered anyone's business other than the individual, his doctor, and his family and friends. (OK, I still bear a grudge over the fact that a minister my mom never knew attempted to inject himself into her death process and "save" her soul when she was too weak to say no, and she had to ask me for help in getting rid of him and it made me look Satanic, but still... I'd take him sniffing around over a government panel any day.)

Hell, I feel so strongly about keeping the government out of death and dying that I wouldn't even want them near my dog. When my beloved dog Puff died, it was an agonizingly personal experience, and I finally decided to pay the vet to come to the house to help him die peacefully and painlessly. If the vet had started talking about a need for a government panel, I'd have been absolutely horrified -- and justly so. There are some places the government does not belong. The problem is, the government doesn't seem to think so, nor do the people who want to run our lives, and now run our deaths.

I don't want the government running my death, OK? Not only is it much too personal a thing, but governments have poor track records in that regard.

Government death panels?

I can't believe I'm even seeing such creepy looking words, much less that they're being debated.

I realize the president made it clear that he had a green agenda, but I thought he meant saving the environment, not telling me that maybe it's time for me to just take a pill.

Obama-greenhealthcare2.jpg

Here's what he said:

"Maybe you're better off not having the surgery, but taking painkillers."
No wonder 84 year old Ed Koch fell out of love with the doctor-in-chief.

posted by Eric on 08.13.09 at 12:32 PM





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What's a government death panel?

Anonymous   ·  August 13, 2009 01:47 PM

Oh, I forgot! We're not supposed to call them that!

http://justoneminute.typepad.com/main/2009/08/there-he-goes-again.html/

Eric Scheie   ·  August 13, 2009 01:54 PM

Problem is, health care has become such a huge sucking-money-pit only because of the huge advances and improvements and discoveries that just keep on coming, year after year, and that allow us to stay alive longer and longer and . . . .

But, the easy (i.e., cheap) advances were all found and adopted years ago, leavings us today with the very, very complex (i.e., expensive) ones. We can now successfully treat diseases that used to kill us off by the millions! Even better, recent research into the basic aging process promises to be very fruitful. But, to do so, we need to do things like synthesize some drug that requires $30 million worth of machinery to make one dose, or expend nine million man-hours stirring the test tube in one specific direct (depending on which side of the equator you're on) using unicorn tails, or . . .

We've not yet had the national discussion about how, sure, we can keep everyone alive forever, but it'll cost umpti-trillions per day to do it, and we don't have umpti-trillions, so we can't make that choice, even though we've always been gung-ho for all possible heroic measures in treatment.

So, yeah, the ONLY possible resolution to the rising costs of care lies somewhere in that discussion - we are going to have to draw lines, and enforce rules, and it's going to be cold and bitter while we get used to it. But, bottom line is, we cannot continue to spend the equivalent of a NASA mission on each and every premature and undeveloped baby, or on each and every 96-year-old bedridden paraplegic emphysemic beri-beri patient.

We are going to have to learn how to say "Grandpa could live longer if I gave him this little pill, but I only have one of these little pills, and we have twenty people who need it, and he's not the one with the highest criteria score, so we're going to let him die."

It's one thing to say that prices are too high. If, in fact, someone has to wander through the jungles of Borneo catching thirty-five rare purple-rimmed horned toads so that the three epithelial cells at the very end of each of their tails can be cut off and blended with yogurt because that's the only known way to make one dose of this new miracle drug that stops arthritis, then we're going to have to pay a ton for it. Not everything can be "affordable."

bobby b   ·  August 13, 2009 02:03 PM

I'm glad this fight about Obamacare occurred.

The bill as outlined, which really means zero, seems atrocious to me. But it has got people interested in costs and effects. And being interested they examine what is said and done more carefully.

I say the outlined bill means zero because Congress has already proved it will put in or alter hundreds of pages of previously unseen text at any time, including after the votes are taken.

And using the reconciliation committees as a way to rewrite means the word of those who passed the bill means absolutely nothing.

The Congress is so corrupt we should believe nothing they say. And I mean from either side of the aisle.

We won't get good results out of bad government. Either results about economics or medicine or any other topic that draws their interests.

I wish I had a solution. But adopting bad ideas and programs to solve a problem isn't the way to solve a problem. That is indeed change but so is suicide.

K   ·  August 13, 2009 07:24 PM

In which section are these death panels mentioned?

Alan Kellogg   ·  August 13, 2009 07:26 PM

Remember: It was Soylent Green that's made of people.

We should all now quietly start writing down our favorite color and the kinds of music we like best. Let them take it from there...

John Burgess   ·  August 13, 2009 07:45 PM

Eric:
Thank you for the personal insight. Like you, I've witnessed too many close friends coping with end of life decisions. The last fucking thing they would have wanted was some government asshole intruding.

Frank   ·  August 13, 2009 10:33 PM

When saving money means that a government agency or a large health-care organization is the one that benefits, you can see why the decision is almost always to spend more. But when the beneficiary of the saved money is a loved one, then some real saving might occur.
Thus the benfits of the health care savings account, where the unused monies from Grandpa might pay for a better nursing home for Grandma or be the seed money for his grandchildren's college fund.
But, this goes agains the "grow the government" mantra of both the Dems and GOP, so it does not have a chance in hell of happening.

pablo panadero   ·  August 14, 2009 11:09 AM

Alan they have been removed:

http://www.latimes.com/news/nationworld/nation/la-na-health-end-of-life14-2009aug14,0,4670272.story

even though they "weren't there."

They're not referred to as "death panels," but as counseling for "end-of-life decisions."

Not that there's anything wrong with that; I just don't want even a hint of government involvement in it.

Eric Scheie   ·  August 14, 2009 02:51 PM

Eric,

The story you linked to did not refer to the specific section where the 'death panels' were proposed. I've blogged on this, and the closest Section 1233 comes to any 'death panel' is;

‘‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that— ‘‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;

...

‘‘(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.

Which expressly refers to a panel of advisers regarding advance care directives themselves. Such a panel would have no say in how a patient would be treated, only in the paperwork regarding a patient's directions whereto treatment under specific circumstances. You need to remember context.

Alan Kellogg   ·  August 14, 2009 06:51 PM

There's also this:

***QUOTE***

(b) EXPANSION OF PHYSICIAN QUALITY REPORTING INITIATIVE FOR END OF LIFE CARE.—
(1) PHYSICIAN’S QUALITY REPORTING INITIATIVE.—Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w–4(k)(2)) is amended by adding at the end the following new paragraphs:
"(3) PHYSICIAN’S QUALITY REPORTING INITIATIVE.—
"(A) IN GENERAL.—For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life- sustaining treatment.
"(B) PROPOSED SET OF MEASURES.— The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures."

***END QUOTE***

OK, end of life panel.

I don't want the government -- or government guidelines -- involved when I'm dying.

I'm against government medicine, period. "End of life" counseling or otherwise. And I say this as someone who is not opposed to people having assistance with dying. But from their doctors only.

The government should be nowhere in sight.

Eric Scheie   ·  August 14, 2009 07:22 PM

Love that picture.

TallDave   ·  August 16, 2009 02:54 PM

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