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Anyone who has helplessly watched a loved one struggle with terminal cancer or other fatal disease knows the agony, turmoil and inner conflict of dealing with end-stage circumstances as death approaches. Indeed, many Americans now write living wills precisely to avoid the burdens that could fall on our children, spouse or siblings if we do not dictate our wishes for end-stage treatment.

If we had rather avoid being trapped in unbearable pain or a vegetative state of brain death, we may specify in our living will, and tell our physician, that we prefer a DNR code -- Do Not Resuscitate notice -- on our hospital chart. Many of us urgently wish to avoid bankrupting our family to sustain us in a futile brain-dead twilight zone from which there is no return.

Many among us also reasonably believe that if we do not assertively express our preferences for the treatments that may be offered, our loved ones will frantically demand extreme measures to stave off certain death, needlessly prolonging our agony, and theirs, before death wins.

It is just such universal fears that prompted Republican Sen. Johnny Isakson, of Georgia, to propose on July 7 an amendment to the chief Senate health care reform bill to allow Americans "to obtain assistance in formulating their own living will and durable power of attorney."

A week later, House Democrats unveiled a reform bill that would provide Medicare patients coverage for optional, voluntary consultations with physicians for advice on life-sustaining treatment and end-of-life services, including hospice care. The provision instructed Medicare to measure the quality of end-of-life care.

Three days after that, on July 17, a former New York lieutenant governor, Betsy McCaughey, a strident critic of the Clinton health reform initiative in 1994, arbitrarily distorted those measures in a radio talk show. She said, falsely, that the House bill "would make it mandatory -- absolutely require -- that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go into hospice care."

On July 27, House Republican leader John Boehner, of Ohio, deliberately distorted the meaning of the optional consultations to suggest in a prepared statement that such counseling "may place older people in situations where they feel pressured to sign end-of-life directives they would not otherwise sign. This provision", he continued, "may start us down a treacherous path toward government-encouraged euthanasia if enacted into law."

AARP attempted to correct the House Republican Leader's statement, but to no avail. On Aug. 7, Sarah Palin, who herself had previously advocated similar information in voluntary sessions, wrote on her Facebook page: "The America I know and love is not one in which my parents or my baby with Down syndrome will have to stand in front of Obama's death panel so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."

When asked by the Washington Post on Aug. 10 about Ms. Palin's statement, Sen. Isakson, said, "I just had a phone call where someone said Sarah Palin's Web site had talked about the House bill having death panels on it where people could be euthanized. How someone could take an end-of-life directive or living will as that, is nuts. You're putting the authority in the individual rather than the government. I don't know how that got so mixed up."

Neither do we, except for our knowledge of the lies that anti-reform activists are fanning. Republican commentators, including Rush Limbaugh, Fox's Glenn Beck, and columnist Cal Thomas have rushed to embrace and fuel the euthanasia scare and tie it to Nazi history. With such rabid right-wing media coverage of a phony charge contrived out of thin air, some seniors and many fair-minded people have been persuaded to believe in this big lie.

Those pushing the falsehood are shamelessly ecstatic. Many on the health industry lobby payroll want to kill health reform to preserve private insurers' big profits, and they'd be happy to derail President Obama's agenda, as well. It's a two-fer for them, but a huge loss for ordinary Americans who may someday want such counseling.

Alas, reason and honesty do not always prevail. Republican Sen. Charles Grassley, of Iowa, one of the six senators who are drafting the Senate's health reform bill, disclosed Thursday that the useful counseling provision would be withdrawn from the Senate bill because of the way it has been played. That confirms both the power of anti-reform lobbyists and the power of ignorance and fear to sabotage health reform.

That's tragic. As Elizabeth Edwards said about her terminal cancer during her husband's campaign for the Democratic presidential nomination, "We're all terminal. Some of us just know it sooner than others."

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