ISSUES: CHRISTIANS AND THE WORLD

CHRISTIANS AND THE WORLD






For Americans who think so-called 'death panels' aren't anywhere on the horizon, something similar already is:

The Death Book for US veterans:
How to say 'Hurry up and die!'
By JIM TOWEY

August 22, 2009


Mr. Towey, president of Saint Vincent College, was director of the White House Office of Faith-Based Initiatives (2002-2006) and founder of the nonprofit Aging with Dignity.


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 [under Pres. Clinton] 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?

One can only imagine a soldier surviving the war in Iraq and returning without all of his limbs only to encounter a veteran's health-care system that seems intent on his surrender.

I was not surprised to learn that the VA panel of experts that sought to update "Your Life, Your Choices" between 2007-2008 did not include any representatives of faith groups or disability rights advocates. And as you might guess, 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.

Many years ago I created an advance care planning document called "Five Wishes" that is today the most widely used living will in America, with 13 million copies in national circulation.

Unlike the VA's document, this one does not contain the standard bias to withdraw or withhold medical care. It meets the legal requirements of at least 43 states, and it runs exactly 12 pages.

After a decade of observing end-of-life discussions, I can attest to the great fear that many patients have, particularly those with few family members and financial resources. I lived and worked in an AIDS home in the mid-1980s and saw first-hand how the dying wanted more than health care — they wanted someone to care.

If President Obama is sincere in stating that he is not trying to cut costs by pressuring the disabled to forgo critical care, one good way to show that commitment is to walk two blocks from the Oval Office and pull the plug on "Your Life, Your Choices."

He should make sure in the future that VA decisions are guided by values that treat the lives of our veterans as gifts, not burdens.





Another end-of-life item:


Thai Catholics and Buddhists speak up
on biological will and right to life
by Weena Kowitwanij



A constitutional revision on laws governing the end of life is being drafted in the country. A Buddhist monk says pain and sickness must be accepted; a Catholic priest stresses the importance of spiritual care.


Bangkok, Aug. 22 (AsiaNews) - "The day before his death, I went to the seaside with my son. On the way home, he laid his head on my shoulder and told me 'Mom, I am so happy today'. The next day he died in my arms".

This is how a mother describes the death of her 10 year old child, who had long suffered with leukaemia to AsiaNews. "I still remember - adds Rangsima Boonyabhum - his last words ... 'Bye ... Mom'."

In Thailand the issues of biological wills and end of life rights are being debated at a conference organized by the National Committee for Healthcare.

During the meetings there was talk of the "right to self determination" and the "right to refuse treatment for the terminally ill”.

The participants also expressed views and impressions on the National Health Act of 1997, paragraph 12, which establishes the right of the patient to set the limits for care in the event of a coma or vegetative state. It also provides for authorized "therapies that put an end to pain".

Chatree Charoensiri, Secretary General of the National Committee for Healthcare, said that several factors should be taken into consideration in the revision of paragraph 12 of the Act, among them "the law, society, culture and religion", so as not to trigger "conflict" but ensure "the patients choices are respected”.

At the conclusion of the conference, the doctor says, the Committee will prepare a draft "to be submitted to the executive for approval."

The World Medical Association guarantees the right of self determination to the patient. But the Thai Constitution and the draft revision of the law make clear reference to human dignity and the right to life.

Phra Phaisan Visalia, a Buddhist monk, emphasizes that "pain, disability and illness should not be regarded as enemies, but with accepted with wisdom”. He states that "people have to die a natural death" without external interventions or instruments that constitute a "passive euthanasia", above all, he adds, there must always be respect for life. [This is all part of basic Buddhist doctrine - that life is suffering, and that age, sickness and death are inevitable, but every life - including that of the tinest flea - is sacred and must not be snuffed out by any person.]

John Baptist Siranon Sanpetch, director of San Camillo in the diocese of Ratchaburi, appreciates the groundwork laid down in Article 12, but clarifies that any eventual biological testament must “facilitate agreement between doctor and patient about the type of treatment to be administered".

The physician must continue to alleviate the symptoms of the disease, but these elements must be united to "spiritual care and support of relatives."