VFlorsheim, Stewart NEW
VFlorsheim, Stewart NEW

Cruel rumors about death panels have no place in health care debate

One of the unfortunate fallouts of President Barack Obama’s health proposal has been the rumor that it would promote government-sponsored “death panels” — a sinister group that would decide which patients are worthy of living.

Well, nothing could be further from the truth.

Stewart Florsheim

As usual, distortions like this begin with groups that have a political agenda. According to the New York Times, the ball was set in motion as early as Nov. 23 by the Washington Times, which suggested that the new administration might be inclined to support a euthanasia program similar to the Nazis’.

The Washington Times editorial described the Aktion T4 program in which “anyone anywhere in the Third Reich was subject to execution who was blind, deaf, senile, retarded, or had any significant neurological condition.”

A section of the health care bill being discussed in the House gave the conservatives all the fuel they needed. However, the now-famous Section 1233 simply ensures Medicare reimbursement for voluntary consultations about end-of-life treatment between patients and their medical practitioners every five years, or more often in the case of a life-threatening change.

The consultations might include discussions about hospice, options for treatment (including pain management) and the importance of having an advance directive. The bill would help validate and support the work of palliative care doctors whose services are often subsidized by the rest of the hospital because they do not generate much revenue.

The Journal of the American Medical Association just reported on a new study showing that patients and their families benefit from end-of-life counseling. The study included 332 patients in New Hampshire and Vermont who had been diagnosed with terminal cancer. Half were assigned to receive usual care. The other half received usual care in addition to counseling about managing symptoms, communicating with health care providers and using hospice.

The study said that those who received the counseling scored higher on quality of life and mood measures than patients who did not. They also lived longer, by an average of more than five months.

Many influential organizations support the measure, including AARP, the lobby for older Americans. They said that some of the comments against the measure were rife with gross distortions, and they believe that it would help provide people with better information about the treatment options available to them. The consultation provision is also endorsed by the Providence Health System, a Catholic health care provider.

Judaism has always supported the importance of being informed as a means to make the right decisions — to ask questions, to debate, to understand.

The religion also considers palliative care an appropriate measure to take if someone is suffering at the end of life.  Although Section 1233 addresses only reimbursements for end-of-life consultations, Judaism goes further in addressing aid-in-dying.

The Talmud relates the story of the death of a great sage, Rabbi Judah ha-Nasi. The rabbi was suffering greatly but his students prayed with fervor in the courtyard to keep him alive. Out of compassion for his suffering, his maidservant dropped a jar from the rooftop — an action that so stunned the students that they became silent, and the rabbi died.

This story has often been used to justify the removal of life support, validating the right of a terminally ill patient to die with dignity. (A contemporary version of this story would hopefully include an advance directive.)

Section 1233 is clearly about the importance of transparency and choice. It has nothing at all to do with the government making end-of-life decisions for individuals.

At a town hall meeting a couple of weeks ago, President Obama said it best: “If Medicare is saying you have the option of consulting with somebody about hospice care, and we will reimburse it, that’s putting more power, more choice in the hands of the American people, and it strikes me that that’s the sensible thing to do.”

Former Alaska Gov. Sarah Palin popularized the specter of the “death panels” that would rule on whether to treat defenseless patients like her son Trig, who has Down syndrome.

The end-of-life language became so radioactive that the Senate Finance Committee decided to strike it from its version of the bill.

The section is still in the House bill, and hopefully it will survive the rounds of negotiations that are sure to come. If not, many Americans will remain in the dark about end-of-life choice, and suffer deaths that are painful and undignified.

Stewart Florsheim is a board co-chair of Compassion & Choices of Northern California, an S.F.-based organization that helps the terminally ill make end-of-life decisions. A Piedmont resident, he is also on the board of trustees at Oakland’s Temple Sinai.

Stewart Florsheim
Stewart Florsheim

Stewart Florsheim has published several books of poetry, including “Ghosts of the Holocaust,” an anthology of poetry by children of Holocaust survivors. He lives in Piedmont.