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"Death Panels"

So the guys talking about Death Panels, who hate the bill for that reason, are represented on The Daily Show by some woman in an interview that went over, and went out on the Internet unedited. And I watched it. And I realized, their complaint *can* be explained in terms that we can understand. I still disagree, but I understand now.

Her complaint, the one that actually came through in that interview: the bill provides positive incentives for doctors to discuss a living will with a patient, convincing them to have something on file saying what to do in the case they're incapacitated. She, and those like her, believe that in a time of good health, one is much more likely to say "yes, I don't want to go on living that way" than when faced with the actual situation.

Their problem is with living wills themselves; in some ways it's an extension of Terry Schiavo, but even worse; if Terry Schiavo had signed a living will asking to be removed from life support, these people would have argued that it should be ignored. I think. From what I hear in that interview.

So, they don't like living wills, and they really don't like the idea that more people will have them. It further validates what is, to them, a horrible weapon for a person to wield against their future selves... And in some ways, living wills provide the only legal path to assisted suicide in the country right now, albeit in extremely limited circumstances. And everyone knows what a great PR face Jack Kevorkian put on that issue.

So, I'll say this; while I disagree with the points, and I especially disagree with the way they are presenting their point... I do believe they're not necessarily making something out of nothing here; there is a bit of substance behind their complaint, and, if only we could have more civil conversations continuing where The Daily Show left off, we might find some common ground... eventually. Maybe.

Comments

( 40 comments — Leave a comment )
navrins
Aug. 24th, 2009 05:12 am (UTC)
Sounds like what I saw on TDS myself. Once Stewart stopped interrupting her long enough for her to actually say what she was complaining about, I lost interest. Wait, she's comparing "grading doctors on asking people to write down what they want done to them, and then doing what was written" do "the government will set up committees to decide who lives and who dies?" Right, then.
tirianmal
Aug. 24th, 2009 12:12 pm (UTC)
How does the requirement that Medicare pay for the services for a sick or elderly person to discuss (not require to be implemented, simply -discuss-) things such as living wills, DNRs, etc ... become a "Death Panel".

Also, what navrins said.
tirianmal
Aug. 24th, 2009 01:02 pm (UTC)
Incidentally ... she never did find that section on page 432.

Because it doesn't exist?
nathanw
Aug. 24th, 2009 12:20 pm (UTC)
You're bending over backwards to try and listen to them in the most positive possible light. If what they meant was "Living wills are dangerous and shouldn't exist", they could say that.
navrins
Aug. 24th, 2009 01:05 pm (UTC)
Actually, what I heard (on TV) was, "Living wills are dangerous, and doctors shouldn't have to follow them." Which I think is even worse. I mean, okay, if you think I shouldn't try to plan ahead, I can accept that. I don't agree, but I can kinda see your point, that I might not be able to make a good decision about how to handle pain and stress that I've never experienced. Personally, I think I'll make a much better decision when I'm not under that pain and stress than I would when I am, but I can see your point too.

But you think that when I do plan ahead, my doctor should ignore what I said and do what he thinks is good for me instead? Bzzzt. Sorry. I can't accept that.
(no subject) - orbitalmechanic - Aug. 24th, 2009 01:31 pm (UTC) - Expand
(no subject) - dcltdw - Aug. 24th, 2009 02:03 pm (UTC) - Expand
(no subject) - orbitalmechanic - Aug. 24th, 2009 02:07 pm (UTC) - Expand
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(no subject) - dcltdw - Aug. 24th, 2009 02:40 pm (UTC) - Expand
(no subject) - narya - Aug. 24th, 2009 02:47 pm (UTC) - Expand
(no subject) - orbitalmechanic - Aug. 24th, 2009 02:54 pm (UTC) - Expand
(no subject) - narya - Aug. 24th, 2009 04:26 pm (UTC) - Expand
tirianmal
Aug. 24th, 2009 02:20 pm (UTC)
I had listened to this interview this morning before work and it occurred to me that you're completely right.

This isn't an issue with the HC bill, because that is simply trying to both provide payment for and normalization of a service that already exists.

It is that folks like this woman think that DNRs just shouldn't exist. Mind you, she doesn't say that, but let's examine her premise. In the heat of the moment, they don't want you to have given up your "right to life". While others, in the heat of the moment, don't want to have to make a life or death decision ... they'd rather have made that when they were calm and rational.

This isn't a "HC bill is ebil" argument, it's a fundamental point of view that they are very likely to never change.

And the cynical part of me says that she doesn't even CARE about that point of view. She's just using it as a wedge issue because she CAN.

Edited at 2009-08-24 02:21 pm (UTC)
(no subject) - crs - Aug. 24th, 2009 02:22 pm (UTC) - Expand
(no subject) - (Anonymous) - Aug. 24th, 2009 02:28 pm (UTC) - Expand
(no subject) - nathanw - Aug. 24th, 2009 02:30 pm (UTC) - Expand
abce
Aug. 24th, 2009 02:21 pm (UTC)
Those aren't the only issues. I'd suggest research on:
* Ezekiel Ehmanuel's long stated opinions on comparative effectiveness research, and life-quality years in determination of recipients of health care.
* The VA's "Death Book", which represents a current bureaucratic implementation of the not-really "voluntary"[1] consultations.

[1] The word "voluntary" for a consultation your practitioner is likely to be required to push, and you can avert, has about the same meaning as the word "right" in "The EFCA doesn't remove the right to a secret ballot"
tirianmal
Aug. 24th, 2009 02:34 pm (UTC)
But there's nothing in the language of that section (or maybe you need to find it for me) that says that these consultations will be mandatory.

In fact, there's nothing that says these consultations would be pushed or increased and in fact, if I read some of that section correctly, would be not be possible in States that have provisions in law that make these consultations either illegal or not wanted.
(no subject) - abce - Aug. 24th, 2009 02:48 pm (UTC) - Expand
(no subject) - tirianmal - Aug. 24th, 2009 03:09 pm (UTC) - Expand
(no subject) - tirianmal - Aug. 24th, 2009 03:16 pm (UTC) - Expand
abce
Aug. 24th, 2009 02:49 pm (UTC)
And really,
"Keep your grubby laws off my body" should be a sufficient reason for any liberal to oppose government-controlled health care.
dpolicar
Aug. 24th, 2009 06:40 pm (UTC)
Should it?

If the alternative is insurance-industry-controlled healthcare, I really don't feel like "Oh, good, I'm free of grubby laws controlling my body, now I just have these lovely private corporate policies controlling my body, I win!" is a particularly sensible position.

So... I dunno. Maybe I'm just not a good enough liberal.
tirianmal
Aug. 24th, 2009 03:00 pm (UTC)
So, we're getting rid of Medicare and Medicaid too?
kirisutogomen
Aug. 24th, 2009 03:53 pm (UTC)
Let's say that the bill also included a section that said, "and if someone shows up at a family planning clinic looking for an abortion, we will pay the clinic extra money if they first talk to the patient for a while about alternatives to abortion."
orbitalmechanic
Aug. 24th, 2009 04:44 pm (UTC)
Given that federal funding for abortions is very stringently restricted and in some cases impossible to obtain, your scenario would be an improvement for many people.
(no subject) - kirisutogomen - Aug. 24th, 2009 05:51 pm (UTC) - Expand
(no subject) - tirinian - Aug. 24th, 2009 07:33 pm (UTC) - Expand
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(no subject) - dpolicar - Aug. 24th, 2009 08:57 pm (UTC) - Expand
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(no subject) - dpolicar - Aug. 25th, 2009 12:50 am (UTC) - Expand
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(no subject) - tirianmal - Aug. 25th, 2009 07:04 pm (UTC) - Expand
(no subject) - kirisutogomen - Aug. 25th, 2009 07:17 pm (UTC) - Expand
dpolicar
Aug. 24th, 2009 06:41 pm (UTC)
I was going to respond here, but it got long, so I moved it here.
dpolicar
Aug. 24th, 2009 09:04 pm (UTC)
Oh, and as long as I'm here, I'll also say that anyone who engages in this topic without drawing a clear distinction between (on the one hand) creating situations in which people are given a choice but are free or perhaps encouraged to choose "the wrong thing", and (on the other hand) creating situations in which people are denied a choice at all, gives up a lot of credibility in my eyes.
( 40 comments — Leave a comment )