End of Life Planning - A Rare Obama Idea I Can Live With

[Bitsy]

I don't agree. There is nothing wrong with making clear that to people that foregoing treatment may be the best option in many cases. Forcing doctors to pretend that all choices are equally reasonable is nonsensical. If people feel pressured to choose the option that hastens death then so be it. People have no right to futile treatments at taxpayer expense. Nothing wrong with them being told that.

Frankly, my own opinion is I should be entitled to determine the time and manner of my death. If I am diagnosed with a disease like Alzheimer I will make my exit long before the disease destroys the lives of my loved ones. I resent the interference of moralistic busybodies worried about "slippery slopes" that seek to prevent people like me from exiting life on my terms in the company of the people I care about. When I look at the dutch stats where 11% of cases where death might have been involutary means in 89% of cases the deaths were exactly what the person wanted. 9 out 10 is good enough for me given the harms caused by forcing those 9 out 10 people to live in suffering.

Good post, TimG.

Until I read all of of Scribblet's fears and anxieties, I did not realize that this discussion was relative to Canada, and did not know that end of life discussions with doctors was an issue for Canadians. Has it resulted in premature deaths due to pressuring from doctors? Are mentally challenged adults being counseled to refuse life saving treatments?

[TimG]

Until I read all of of Scribblet's fears and anxieties, I did not realize that this discussion was relative to Canada, and did not know that end of life discussions with doctors was an issue for Canadians.

These kinds of conversations go on all of the time. I know my own 88 year old grandmother was told that another round of chemo would be unlikely to succeed and she should let the disease take its course. That is the choice she ended up making.

Euthanasia is where the real debate is here and that I why the thread drifted. There were a couple high profile cases in 90s that brought the issue into public discussion (Latimer and Sue Rodriguez) but there have been no real changes to the laws even though there is consider public support for a change.

[scribblet]

I don't agree. There is nothing wrong with making clear that to people that foregoing treatment may be the best option in many cases. Forcing doctors to pretend that all choices are equally reasonable is nonsensical. If people feel pressured to choose the option that hastens death then so be it. People have no right to futile treatments at taxpayer expense. Nothing wrong with them being told that.

Frankly, my own opinion is I should be entitled to determine the time and manner of my death. If I am diagnosed with a disease like Alzheimer I will make my exit long before the disease destroys the lives of my loved ones. I resent the interference of moralistic busybodies worried about "slippery slopes" that seek to prevent people like me from exiting life on my terms in the company of the people I care about. When I look at the dutch stats where 11% of cases where death might have been involutary means in 89% of cases the deaths were exactly what the person wanted. 9 out 10 is good enough for me given the harms caused by forcing those 9 out 10 people to live in suffering.

That's fine, it's a good discussion. I agree we should be entitled to make those decisions, but as I've stated, looking at what is happening in the Netherlands and Belgium for instance, I have concerns about the 'slippery slope'

[wyly]

The point was that there were and are problems, 11.3% of the total number of the 14,691 deaths in the country in the Netherlands are cases of involuntary euthanasia in which people were killed against their will. Euthanasia is about making it legal for doctors to help people to die, which includes withdrawal of care and cessation of treatment, which is fine for mentally capable,consenting adults.

involuntary does not mean those euthanized objected, it means they no longer were no longer able to make the decision on their own, no one is euthanized against their will...

* the patient's suffering is unbearable with no prospect of improvement

* the patient's request for euthanasia must be voluntary and persist over time (the request cannot be granted when under the influence of others, psychological illness or drugs)

* the patient must be fully aware of his/her condition, prospects and options

* there must be consultation with at least one other independent doctor who needs to confirm the conditions mentioned above

* the death must be carried out in a medically appropriate fashion by the doctor or patient, in which case the doctor must be present

* the patient is at least 12 years old (patients between 12 and 16 years of age require the consent of their parents)

Euthanasia remains a criminal offense in cases not meeting the law's specific conditions, with the exception of several situations that are not subject to the restrictions of the law at all, because they are considered normal medical practice:

Withdrawal of care for whatever reason can lead to involuntary deaths. The slippery slope premise is supported by what is happening in the Netherlands where it is now permitted to euthanize not only the competent terminally ill, but also for infants with serious handicaps, comatose patients, and even people suffering from severe depression.

the competent terminally ill have the right to choose their own method of death,a natural slow and painful death or MD assisted quick and painless...the protocol for infants involves both parents and cannot progress without their 100% consent and it must be approved by a medical team and one outside MD who has no tie to the case... and following the death there is a coronor investigation, the District Attorney, Attorney General and finally the Minister of Justice must sign off ...to date there has not been one prosecution for wrongful death of an infant...

you have very inaccurate preception of what is going on there...

and euthanasia has being going on in the netherlands for at least 60-70 yrs it just wasn't talked about openly, now it has laws to guide and protect the MDs help meeting their patients requests for assistance...

Edited December 30, 2010 by wyly

[TimG]

the competent terminally ill have the right to choose their own method of death,a natural slow and painful death or MD assisted quick and painless

Limiting it to people who are likely to die in a few months is too restrictive in my opinion. The only requirement that I think is necessary is a requirment for an incurable physical medical condition that will cause great suffering if allowed to proceed naturally (i.e. Alzheimers).

[wyly]

Limiting it to people who are likely to die in a few months is too restrictive in my opinion. The only requirement that I think is necessary is a requirment for an incurable physical medical condition that will cause great suffering if allowed to proceed naturally (i.e. Alzheimers).

I would think for alzheimers people need to have a living will requesting death at some point we can't take it for granted suffers all agree...I've already told my family I will speed up the process on my own I won't take the chance of becoming so disabled that I no longer can do it thereby become an enormous financial burden to the family...

MD assited suicide for those facing illnesses such as alzheimers should be allowed...and so should it for people who are just tired of life...if I'm 80-90 and I have no desire to live anymore, I want the option to die on my terms even if I'm not ill...

[TimG]

I would think for alzheimers people need to have a living will requesting death at some point we can't take it for granted suffers all agree

I was assuming that once the diagnosis is made the person will still be competent enough to stipulate when and how they wish to die. Once their mind is gone it is not possible to consent.

MD assisted suicide for those facing illnesses such as alzheimers should be allowed...and so should it for people who are just tired of life...if I'm 80-90 and I have no desire to live anymore, I want the option to die on my terms even if I'm not ill...

The only concern I have are people suffering from clinical depression (i.e. something that can be treated and managed). We don't want a system where people in temporary ruts get help killing themselves instead of help with their condition. With that caveat, I agree that there are hypothetical scenarios where a healthy person may wish to exit early.

[bloodyminded]

Money is always behind the decision whether you like it or not. Even with government assistance caring for a special needs child costs a lot of money. Do you really think that does not factor into the decisions made by parents of premature babies? Why do you insist that money should be kept out of the discussion?

I agree. That we--almost everybody--considers financial matters to be crude and ugly in certain specific situations doesn't alter one bit the objective reality.

The only concern I have are people suffering from clinical depression (i.e. something that can be treated and managed). We don't want a system where people in temporary ruts get help killing themselves instead of help with their condition.

Good point. I know a man who failed a suicide attempt, and he's damn glad he failed.

Edited December 31, 2010 by bloodyminded

[LonJowett]

involuntary does not mean those euthanized objected, it means they no longer were no longer able to make the decision on their own, no one is euthanized against their will...

It's hard to believe someone would be dumb enough to think they were euthanizing people against their will on their slippery slope. I guess you don't need brains to comment in online forums.

[Bitsy]

Obama has no balls…… :angry:

The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday.

http://www.nytimes.com/2011/01/05/health/policy/05health.html?hp

[Timothy17]

The article excerpted below highlights one area on which I am in strong agreement with the Obama administration. Politicians have been afraid to face the consequences of ever-expanding life spans on medical care, medical insurance, social security and private pension plans.

The simple fact is that society's financial expectations take into account the first 22 years or so of a person's life as being non-income producing, and avout seven years at the end of what was then a 72 year life span. Thus, people worked for more than half their life span. Now, with people routinely surviving into their nineties, people often work for about 43 years out of a 90 year life.

The numbers don't work.

Also, end of life heroics result in a poor quality of life. A person in their 40's recovering from, say, an appendectomy will resume a full, productive life. Not so with someone who is 88.

Obama Returns to End-of-Life Plan That Caused Stir

(link to full article)

By ROBERT PEAR

Published: December 25, 2010

WASHINGTON — When a proposal to encourage end-of-life planning touched off a political storm over “death panels,” Democrats dropped it from legislation to overhaul the health care system. But the Obama administration will achieve the same goal by regulation, starting Jan. 1.

Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

****************

Under the new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care, which may include advance directives to forgo aggressive life-sustaining treatment.

Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.

The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.

Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.

It's cowardly at least ; at worst, an out-right abandonment of our duty to life.

Misanthropy, under whatever guise or manifestation, should be resisted by all citizens of good will with strength and vigilance.

We are not livestock.

[jbg]

We are not livestock.

And the financial resources are not unlimited as well.

[Timothy17]

And the financial resources are not unlimited as well.

Then man-up. Any coward can cow from a fight, any sloth can choose not to bother, but real men do not capitulate to adversity.

The signal reads fight, not flight.

[jbg]

Then man-up. Any coward can cow from a fight, any sloth can choose not to bother, but real men do not capitulate to adversity.

The signal reads fight, not flight.

I do not know how to respond to this borderline-incoherent post.

[Timothy17]

I do not know how to respond to this borderline-incoherent post.

That's what I figured, flight Too bad for you, and for America.

Hopefully someone not afraid to tackle tough issues with real solutions will present themselves.

Edited January 23, 2011 by Timothy17