Obamacare Preview: VA Pushes Death Over Treatment

The firestorm that end of life consultations and cost benefit analysis applied to health care decisions that has plagued the Obama Administration’s attempts at reform, may be headed for more trouble.  When labeled as “death panels”, the administration went into overdrive in an attempt to ease the fears that many seniors had about government bureaucrats deciding when it was time for them to go.  Well, those fears just may have some merit.

The Obama Administration and former general Eric Shinsheki  has ordered the VA to reinstate a program called “Your life, Your Choices”.   First developed under the Clinton Administration in 1997, the program was discontinued under the Bush administration over the moral and ethical questions it raised.  Produced for the VA’s National Center for Ethics in Health Care, the 52-page end-of-life planning document was authored by 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.  As the Wall Street Journal reports, this program is an end of life sales pitch aimed at a vulnerable audience.

“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”).

The spin by the Obama adminstration regarding their end of life counseling is that it would be voluntary.  Not so at the VA, which has ordered all of its primary care physicians to provide end of life counseling to all of its patient without regard for the patient’s wishes.  These men and women have voluntarily stepped into harms way prepared to give their lives for their country.  Now we have the VA asking them to give their lives to save a few bucks.

Ed Morrissey sums it up well,

Perhaps some of the “death panels” rhetoric was overblown, but this is downright disgusting.  The Bush administration was correct in suspending the use of these tactics to push vets into refusing treatment, and the government these men and women defended should be ashamed to have put that in their hands in the first place.  If Obama wants to argue that he won’t bend the cost curve downward at the expense of treatment, maybe he should start by stopping that very policy at the VA – one of the existing “public plans” that need reform much more than the overall health-care system.

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