VA Denia of Care DeathBook
'Your Life, Your Choices,' Stopped by Bush, Revived by Obama

By Tom Blumer (Bio | Archive)
August 20, 2009 - 15:16 ET

If you were a reporter trying to gauge the credibility of Obama administration protests that it is really serious when it says that it will honor patient, doctor, and family treatment wishes in serious illness situations if the government takes an exponentially greater role in health care, you might look into how areas of health care already controlled by the government are dealing with these sensitive matters.

Apparently either no journalist has cared to look, or if anyone has looked, they haven't found anything they believe is worth reporting.

In today's Wall Street Journal, Jim Towey, a former director of the Bush White House's Office of Faith-Based Initiatives and founder of the nonprofit Aging with Dignity, found a troubling, newsworthy, death-encouraging decision that has already been made during Barack Obama's short term in office.

As Towey chronicles and explains, it's in the Veterans Administration, and it really is appalling. Here are key excerpts from his column (bolds are mine):

If President Obama wants to better understand why America's discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Department of Veterans Affairs (VA). He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.

Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."

Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.

"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political "push poll." For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be "not worth living."

The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to "shake the blues." There is a section which provocatively asks, "Have you ever heard anyone say, 'If I'm a vegetable, pull the plug'?" There also are guilt-inducing scenarios such as "I can no longer contribute to my family's well being," "I am a severe financial burden on my family" and that the vet's situation "causes severe emotional burden for my family."

When the government can steer vulnerable individuals to conclude for themselves that life is not worth living, who needs a death panel?

..... only one organization was listed in the new version as a resource on advance directives: the Hemlock Society (now euphemistically known as "Compassion and Choices").

This hurry-up-and-die message is clear and unconscionable. Worse, a July 2009 VA directive instructs its primary care physicians to raise advance care planning with all VA patients and to refer them to "Your Life, Your Choices." Not just those of advanced age and debilitated condition—all patients. America's 24 million veterans deserve better.

Towey wraps by challenging the president "to walk two blocks from the Oval Office and pull the plug on 'Your Life, Your Choices.'"

Don't hold your breath, Jim -- waiting for the president to make the walk, or waiting for anyone else in the press to note a federally-controlled health care system that is realizing the worst fears of those who believe in the dignity of life.