Mike Luciano, a regular reader of and sometime contributor to this site, sent along the following post that takes issue with today’s Lowell Sun editorial:
I imagine that reading a Lowell Sun editorial is like walking through a house where multiple homicides have just occurred. You wander through in a state of disbelief as each turn reveals some new horror that’s beyond description. After you’ve finished touring the place you’re left shaking your head wondering, “What the hell happened here?” as you try to make sense of it all. But the truth is, you can never make sense of something that abominable.
Today’s Sun editorial is nothing short of deranged, rehashing as it does the “death panel” rhetoric that accompanied the health care reform debate in 2009 and 2010. For the record, I opposed Barack Obama’s health care plan in large part because of the individual mandate (which I find pernicious and unconstitutional), but I keep my critiques of it based in reality. However, any criticism of this legislation that presents “death panels” as a serious concern is wholly without merit and distorts the facts of the matter.
The “death panel” line was popularized by Sarah Palin in 2009 when she railed against a provision in the health care legislation that would reimburse doctors who offered optional end-of-life counseling to Medicare patients. That provision was removed and therefore not in the enacted version, but it was implemented in late December as a Medicare policy by the Obama administration before being withdrawn just days later—a development the Sun outrageously calls “a happy ending.”
For those unfamiliar with end-of-life planning, like the Lowell Sun, the point of such counseling is to make sure that patients get the treatment they desire if they are ever the victims of a medical event such as a coma, dementia, or some other affliction that incapacitates them. In most cases people who are incapacitated have no “living will” and thus have not made (legally binding) decisions on what kinds of treatment to pursue, or whether to pursue treatment at all. (Remember Terry Schiavo?) At that point it becomes up to the family members who are often left to wonder just what their ill relative would want.
But this isn’t how the Sun sees it because the editorial staff is looking at the issue through Palin’s Kawasaki glasses, which apparently paint the world the color crazy. Here’s the editorial’s take on end-of-life planning:
“Under the new policy, the federal government would pay doctors who advise patients for end-of-life care, including directives to bypass aggressive, life-sustaining treatment.
“In other words, doctors could tell a patient to die rather than have the federal government pick up the tab for an extra hospital stay and/or expensive medical care.”
Three things about this excerpt:
1. End-of-life planning is optional. No one—not a doctor, not the government—can force a person to engage in a consultation about advanced care. And no one has proposed otherwise.
2. Directives may involve instructions “to bypass aggressive, life-sustaining treatment,” but they may also order such treatment. In the absence of any instructions to the contrary, a comatose person’s children may decide to “pull the plug” because all they can do is speculate what their parent would want, even if they would have opted for “life-sustaining treatment.”
3. “Doctors could tell a patient to die”? Putting aside the atrocious writing, where in America do doctors “tell patients to die”? During end-of-life consultations, the doctor does not dictate what treatment the patient will receive and under what circumstances. The patient does, with the advice of the doctor. To say that “doctors could tell a patient to die” is to speak sinisterly of doctors, whose first job is to do no harm.
In addition, end-of-life planning saves money because patients typically select limited treatment over a life that is sustained but incapacitated. As ABC News noted in a typical account of advanced planning,
“In La Crosse, Wis., such ‘end-of-life consultations’ are already common because of a program put in place by a local hospital.
“As a result of these consultations, La Crosse resident Ann Kottnaur said she now knows that her mother Margaret, who has Parkinson’s disease and dementia, would rather die at home than in a nursing home.
“’By the time we completed it, her health had started to fail,’ Kottnaur said of the end-of-life care consultations.’ So we knew from a long time ago that that was her wish,’ Kottnaur said.
“If La Crosse is any example, people do often choose limits on care for their final months. And the fact is, that saves money. In La Crosse, medical spending in the final year of life averages $18,000. The national average is $25,000.”
Despite the Sun’s insinuations, end-of-life planning has nothing to do with rationing care for older people and everything to do with making sure their wishes are carried out if something were to happen that rendered them unable to make important medical decisions. This editorial constitutes either a willful act of deceit, or one of the most ignorant and stupid commentaries ever to appear in the Lowell Sun. And if Dick Howe would consent, I invite the author to explain himself or herself on this site.