The Corner

Reform Hospice to Thwart ‘Death Panels’

Paid end-of-life counseling and advance planning are not “death panels.” Health care rationing — threatened, but not yet here — presents the real hazard. These issues are apples and oranges.

But we keep hearing that doctors discussing with patients what they want and don’t want are a mortal threat. Here’s the latest, from Betsy McCaughey in a New York Post column entitled ”End of Life: Death Panels are Back”:

It’s being sold as “death with dignity,” but it’s more like dying for dollars. Seniors are nudged to forego life-sustaining procedures and hospital care to go into hospice. That enriches the booming hospice industry and also frees up dollars for the left’s favored social causes.

Why is the government meddling with how we cope with death? The Institute of Medicine doesn’t mince words. Scrimping on seniors will free up money “to fund highly targeted and carefully tailored social services for both children and adults.” Just like ObamaCare. Robbing Grandma to spread the wealth…

It’s the perfect storm of ideology and industry greed, with hospice providers lobbying lawmakers to make end-of-life counseling the standard. And not just once. Hospice advocates want to drill their morbid message into patients’ heads. “It has to be a series of recurring conversations over years,” an industry representative insists.

This is beyond hyperbole. To accept McCaughey’s prescription, one would have to believe that doctors don’t give a fig about their patients and greedily drool over the prospect of the unwanted and unproductive being pushed into the grave. That’s simply not true.

More, one would have to accept the premise that hospice is not humane, but avaricious and abusive. There are horror stories, to be sure, but so many more examples of beneficence and hope in hospice. Irresponsibly trashing hospice can cause real harm to individuals and push society toward accepting assisted suicide!

Besides, advance-care planning is important, and people should not wait until seriously ill or at admission into a hospital.

There is a way to ensure that an advance directive doesn’t become a death panel. Don’t sign a “living will” that gives doctors or bean counters decision-making power.

Rather, prepare a durable power of attorney for health care in which you decide who gets to make choices for you when you can’t. Select someone you trust and who shares/knows your values, and the death-panel threat will fade (until and unless health-care rationing is imposed).

Anyone can go to their lawyer, an expensive proposition, or attend non profits that provide directives consistent with particular approaches.

For example, the Patients Rights Counsel — for which I am a paid consultant — offers a state-specific Protective Medical Decisions Document that contains language the exact opposite of the kind against which McCaughey warns, e.g., it keeps one from being dehydrated to death based on quality of life or euthanized. Similarly, the National Right to Life Committee offers the Will to Live.  

But there is an important reform that would defang even the most callous, money-driven hospice. End what I all the “cruel choice” that currently forces people to choose between the tremendous benefits of hospice and the right to receive life-extending or curative care. 

Do that, and there will be no fears of hospice acting merely as an elephant’s grave yard. Allow the dying to receive hospice care along with other treatments, and being “pushed” into hospice will cease to be a threat.

Opposition to Obamacare needs to be robust, but also responsible. By taking an important issue and turning it into a conspiracy theory, McCaughey has led in the wrong direction. 


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