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Jeff In Milwaukee Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 08:38 PM
Original message
Obama's Death Panels
Quite possibly the most idiotic criticism of health care reform is what Sarah Palin called a "death panel" that will determine if her son Trig will live or die. Frankly, I think a few more years of living with Mama Palin and Trig will welcome the comforting embrace of death, but that has nothing to do with health care.

In the festering swamp that is the brain of Sarah Palin, she's turned the concept of an Advance Directive into some kind of "Star Chamber" where patients are told whether they will live or die. As you might have already guessed, the truth is almost the exact opposite of what spewed from Palin's Facebook page the other day. With an Advance Directive, the patient can tell the healthcare provider what to do.

From a healthcare perspective, the most expensive part of any person's life is the year prior to their death. Some of us cash out quickly, but others can linger for months and even years (see Terry Schiavo). All the while this is causing emotional agony for the family as they try to make the right choice, and its costing the health care system a fortune, as these patients tend to be in ICU's.

As a way to assist families during this time AND to lower the cost of health care, many hospitals and healthcare providers (full disclose: I work for a non-profit healthcare system) are encouraging their patients to file Advance Directives. Also known as a Living Will, this document tells your family and your healthcare provider what you want done in the case of irreversible brain trauma, for example, or in other medical conditions where recovery is not possible, but you are not able to articulate your wishes.

I have twice been in the position of having a parent who is in the final stages of cancer. Fortunately for the family, our loved ones were able to make their wishes clear to us before they slipped out of consciousness. Left to our own devices, we could have prolonged their lives almost indefinitaly. Modern medical technology can keep a patient alive, but healing and curing is another far more difficult matter.

It would have been agonizing for us to make the decision ourselves. I always felt the the last gift our parents gave us was the peace of mind of knowing that this is what they wanted. And they didn't force us to make choices that none of us wanted to make.

Needless to say, politicizing such a personal and agonizing issue is despicable.

If you don't have an Advance Directive, talk to your healthcare provider during your next office visit.
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nightrain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 08:40 PM
Response to Original message
1. thank you. knr
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SharonAnn Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 10:42 PM
Response to Reply #1
14. Yes, we too had parents who'd made their wishes known. It helped to know what they wanted
and that we were following their instructions. Absent the Advanced Directive, it would've been much harder to make the decisions.

My spouse and I just updated ours last week along with updating our wills, etc. I have always believed in letting medical personnel and family know what I wanted in this kind of event.
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dorkulon Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 08:43 PM
Response to Original message
2. ...
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Chemisse Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 08:47 PM
Response to Original message
3. A very nice explanation and a very good idea
Could you share that with the Freepers?

They seem to be a bit confused. I'm sure they would be quite relieved to find out that this gives them choices, not puts them down like a dog. It might be hard to get through to them though, since they scream senselessly whenever someone tries to speak.
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ima_sinnic Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 08:53 PM
Response to Reply #3
6. don't bother. they prefer to remain angry with manufactured outrage.
they already know there is no truth to their "grievances," they just need an excuse to hate the black socialist Muslim communist fascist president.
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Jeff In Milwaukee Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Aug-09-09 08:01 AM
Response to Reply #6
15. For a portion of the Republican Party, I think you're spot on
But there are people who don't understand these issues who might be scared and swayed by this rhetoric. With the talk of "rationing healthcare," which we all know happens all the time, it's just a short leap of illogic to get to "Death Panels."
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ColbertWatcher Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 08:50 PM
Response to Original message
4. If you really think it's stupid ...
... may I invite you to post some satirical stuff about it on the Truthiness Encyclopedia (here)?

Just make sure you register a free account so no one can see your IP address.

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Horse with no Name Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 08:52 PM
Response to Original message
5. Federal law has required healthcare providers (for many years now)
Edited on Sat Aug-08-09 08:57 PM by Horse with no Name
AT THE TIME OF ADMISSION to give each and every patient over the age of 18 information on Advanced Directives and Living Wills.
To allow providers TIME (and still be reimbursed) to discuss this very important and sensitive subject OUTSIDE of an acute illness or hospitalization is very important because I have noticed in my practice that when you approach this subject while a patient is ill, it makes them feel nervous and uneasy--like you know something they don't.
I do not know why people do not understand how important this is to give a patient TIME(when they are not ill)to sit down with their practitioner SOLELY to discuss this without any other medical issues or distractions. It is a PATIENT'S RIGHT to understand their options fully. Discussing it with them when they are ill is never a good idea.
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Blue_In_AK Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 08:57 PM
Response to Original message
7. We are going through this right now
Edited on Sat Aug-08-09 09:03 PM by Blue_In_AK
with my husband's mother who had a heart attack about four weeks ago. She went through bypass surgery, but she developed pneumonia and has not been recovering as quickly as we had hoped. We are letting the doctors do what they can for her -- at this point she is sedated with a feeding tube and oxygen -- but she does have a living will, and if it comes to the point where her kidneys fail or the doctors determine that further efforts are pointless, we will know what to do, we will follow her wishes.

Both of my parents, now deceased, had living wills, and in fact my father was taken from the hospital and died at home, as was his wish. My husband and I both have living wills.

There is nothing scary or macabre about this. I am so disgusted with Sarah Palin for distorting this issue and attempting to foment fear and anger among her supporters. I had hoped that when she stepped down from the governorship, that she would return home and take care of the child whom she is so wont to use as a prop. In my opinion, she poses far more of a threat to that little boy than Obama could have ever thought of being with his health care reform.



ed. I might also add that we are extraordinarily grateful for that government-run Medicare program (and her supplemental AARP insurance) which is paying what I am sure will be an astonomical bill. We have been assured by the hospital and doctors that they will all accept what Medicare and the insurance pays and won't require more.
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Jeff In Milwaukee Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Aug-09-09 08:06 AM
Response to Reply #7
16. Birth and Death Decisions...
When to have a child and when to end one's own life are the most personal and (often) agonizing decisions that an individual can make. Conservatives would LOVE to have the government making those birth decisions (No Abortion. Ever. End of Discussion), and seem to tremble in fear that a government might be somehow involved in end of life decisions.

But let me make it clear (not for you personally, but for others reading this). An Advance Directive has nothing to do with the government. It is a message from you to your family and your healthcare provider making perfectly clear your medical wishes - an Advance Directive is about you, the patient, and has no bearing on your insurance or healthcare providers opinion.
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Hekate Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 09:13 PM
Response to Original message
8. My mother had an Advance Directive; my MIL refused to consider death as an option...
In both families, their wishes were respected. When my mom had a clot to the artery leading to her intestines she knew it was a fatal event and that chances of surgery doing anything to reverse that were slim to none. She was done with surgeries and pain, and all she asked for was morphine and to be allowed to go.

When my MIL had her big stroke she went downhill pretty fast. For a little while it looked like she might regain some ability to speak and so on, but it was not to be. The doctor insisted that she not leave the hospital without a feeding tube, and her sons agreed. One of my BILs took care of her for the next year and a half: diapers, enemas, feeding tube, cleaning the feeding tube -- and on and on through all the 24/7 care of a non-responsive person. This was their mother, and she had always refused to contemplate her own mortality, even to the point of refusing to buy a gravesite when her husband did so. I have to respect the fact that her sons, each in his own way, respected their mother's wishes. And on some level I think she hung around as long as she did until she was finally ready to call it quits.

In my estimation Sarah Palin has gone from being an ambitious buffoon to being one evil mother for putting this idea into gullible minds.

Hekate

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Okie4Obama Donating Member (188 posts) Send PM | Profile | Ignore Sat Aug-08-09 09:15 PM
Response to Original message
9. Because of my grandpa's advance directive last month
when he had an unexpected stroke that took away his ability to speak or eat, we knew exactly what to do: what he wanted. He didn't want a feeding tube. He didn't want heroic measures. He died in peace, without tubes and machines hooked up to him, but with us touching his chest, sending him off with love. There was no fighting among the family on what to do, no accusations of "killing him off" or greediness, no cruelty of keeping my grandpa alive when he was in pain and with no chance of recovery. Screw these crazy people.
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Hekate Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 09:35 PM
Response to Reply #9
11. That's how my parents wanted it too. Condolences on the loss of your grandfather. nt
Edited on Sat Aug-08-09 09:35 PM by Hekate
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nightrain Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 10:14 PM
Response to Reply #9
12. thank you for sharing your experience. Your grandfather's passing sounded
very loving.
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TomClash Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 09:34 PM
Response to Original message
10. Another Repuke tactic
Use the elderly and the disabled as pawns for the Health Insurance Industry's agenda.
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Tx4obama Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-08-09 10:15 PM
Response to Original message
13. Jeff In Milwaukee, I think the title should have been 'The Right-Wing's Imaginary Death Panels' n/t
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Stephanie Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Aug-09-09 08:11 AM
Response to Original message
17. Sample Living Will and Healthcare Proxy:
Edited on Sun Aug-09-09 08:11 AM by Stephanie




And here is the provision in the bill that simply orders Medicare to pay for a consultation with your doctor about these forms. It does not mandate the consulation, or force anyone to sign anything. It simply says that if you would like to discuss these things with your doctor, Medicare will pay him for his time.



http://thomas.loc.gov/cgi-bin/bdquery/z?d111:H.R.3200 :

5 SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
6 (a) MEDICARE.

7 (1) IN GENERAL.Section 1861 of the Social
8 Security Act (42 U.S.C. 1395x) is amended
9 (A) in subsection (s)(2)
10 (i) by striking and at the end of
11 subparagraph (DD);
12 (ii) by adding and at the end of
13 subparagraph (EE); and
14 (iii) by adding at the end the fol
15 lowing new subparagraph:
16 (FF) advance care planning consultation (as
17 defined in subsection (hhh)(1));; and
18 (B) by adding at the end the following new
19 subsection:
20 Advance Care Planning Consultation
21 (hhh)(1) Subject to paragraphs (3) and (4), the
22 term advance care planning consultation means a con
23 sultation between the individual and a practitioner de
24 scribed in paragraph (2) regarding advance care planning,
25 if, subject to paragraph (3), the individual involved has

425
HR 3200 IH
1 not had such a consultation within the last 5 years. Such
2 consultation shall include the following:
3 (A) An explanation by the practitioner of ad
4 vance care planning, including key questions and
5 considerations, important steps, and suggested peo
6 ple to talk to.
7 (B) An explanation by the practitioner of ad
8 vance directives, including living wills and durable
9 powers of attorney, and their uses.
10 (C) An explanation by the practitioner of the
11 role and responsibilities of a health care proxy.
12 (D) The provision by the practitioner of a list
13 of national and State-specific resources to assist con
14 sumers and their families with advance care plan
15 ning, including the national toll-free hotline, the ad
16 vance care planning clearinghouses, and State legal
17 service organizations (including those funded
18 through the Older Americans Act of 1965).
19 (E) An explanation by the practitioner of the
20 continuum of end-of-life services and supports avail
21 able, including palliative care and hospice, and bene
22 fits for such services and supports that are available
23 under this title.

426
HR 3200 IH
1 (F)(i) Subject to clause (ii), an explanation of
2 orders regarding life sustaining treatment or similar
3 orders, which shall include
4 (I) the reasons why the development of
5 such an order is beneficial to the individual and
6 the individuals family and the reasons why
7 such an order should be updated periodically as
8 the health of the individual changes;
9 (II) the information needed for an indi
10 vidual or legal surrogate to make informed deci
11 sions regarding the completion of such an
12 order; and
13 (III) the identification of resources that
14 an individual may use to determine the require
15 ments of the State in which such individual re
16 sides so that the treatment wishes of that indi
17 vidual will be carried out if the individual is un
18 able to communicate those wishes, including re
19 quirements regarding the designation of a sur
20 rogate decisionmaker (also known as a health
21 care proxy).

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Jeff In Milwaukee Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Aug-09-09 03:18 PM
Response to Reply #17
19. Thanks for the reference. Here's another link.
http://liv-will1.uslivingwillregistry.com/forms.html

You can create your own living will. In most states, it doesn't require an attorney.
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troubledamerican Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Aug-09-09 03:08 PM
Response to Original message
18. Bush accused "Fuzzy Math" :: Palin accuses "Death Panels" -- it's pre-emptive accusation.
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