Addressing the lies about the alleged "death panel"
 

WASHINGTON – Former Republican vice presidential candidate Sarah Palin
says the health care overhaul bill would set up a "death panel." Federal
bureaucrats would play God, ruling on whether ailing seniors are worth
enough to society to deserve life-sustaining medical care. Palin and
other critics are wrong.

Nothing in the legislation would carry out such a bleak vision. The
provision that has caused the uproar would instead authorize Medicare to
pay doctors for counseling patients about end-of-life care, if the
patient wishes. Here are some questions and answers on the controversy:

Q: Does the health care legislation bill promote "mercy killing," or
euthanasia?

A: No.

Q: Then what's all the fuss about?

A: A provision in the House bill written by Rep. Earl Blumenauer,
D-Ore., would allow Medicare to pay doctors for voluntary counseling
sessions that address end-of-life issues. The conversations between
doctor and patient would include living wills, making a close relative
or a trusted friend your health care proxy, learning about hospice as an
option for the terminally ill, and information about pain medications
for people suffering chronic discomfort.

The sessions would be covered every five years, more frequently if
someone is gravely ill.

Q: Is anything required?

Monsignor Charles Fahey, 76, a Catholic priest who is chairman of the
board of the National Council on Aging, a nonprofit service and advocacy
group, says no.

"We have to make decisions that are deliberative about our health care
at every moment," Fahey said. "What I have said is that if I cannot say
another prayer, if I cannot give or get another hug, and if I cannot
have another martini — then let me go."

Q: Does the bill advocate assisted suicide?

A: No. It would block funds for counseling that presents suicide or
assisted suicide as an option.

Q: Who supports the provision?

A: The American Medical Association, the National Hospice and Palliative
Care Organization and Consumers Union are among the groups supporting
the provision. AARP, the seniors' lobby, is taking out print
advertisements this week that label as false the claim that the
legislation will empower the government to take over life-and-death
decisions from individuals.

Q: Should the federal government be getting involved with living wills
and end-of-life questions — decisions that are highly personal and
really difficult?

A: It already is.

The government requires hospitals to ask adult patients if they have a
living will, or "advance directive." If the patient doesn't have one,
and wants one, the hospital has to provide assistance. The mandate on
hospitals was instituted during a Republican administration, in 1992,
under President George H.W. Bush.

Q: How does a living will work, and how is it different from a health
care proxy?

A: A living will — also called an advance directive — spells out a
patient's wishes if he or she becomes incapacitated. Often people say
they don't want to be kept alive on breathing machines if their
condition is terminal and irreversible.

A health care proxy empowers another person to make medical decisions
should the patient become incapacitated.

There's also a power-of-attorney, which authorizes another person to
make financial decisions for someone who is incapacitated.

Such legal documents have become standard estate-planning tools in the
last twenty years.

Q: Would the health overhaul legislation change the way people now deal
with making end-of-life decisions?

A: It very well could.

Supporters of the provision say the main consequence would be to
formally bring doctors into a discussion that now takes place mainly
among family members and lawyers.

"When you execute a legal document with your lawyer, it ends up in your
files and in the lawyer's files," said John Rother, a senior policy and
strategy adviser for AARP. "Unless the doctor is part of this
discussion, it's unlikely that your wishes will be respected. The doctor
will be the one involved in any decisions."

The American Medical Association says involving doctors is simple common
sense.

"There has been a lot of misinformation about the advance care planning
provisions in the bill," AMA President Dr. James Rohack said in a
statement. "It's plain, old-fashioned medical care."

Q: So why are some people upset?

Some social conservatives say stronger language is needed to protect
seniors from being pressured into signing away their rights to medical
treatment in a moment of depression or despair