Killing Granny?

Killing Granny?

I've seen some pretty wild claims about the 1000 page Frankenstein that Congress is putting together, and some of them sound like hyperbole. So I was a bit surprised to see Professor Kenneth Anderson over at Volokh Conspiracy indicate that yes, sec. 1233, while not the mandatory "kill granny" bill that some have claimed, is still somewhat troubling. He points to Charles Lane's article in that well-known far right publication, the August 8, 2009 Washington Post:

Section 1233, however, addresses compassionate goals in disconcerting proximity to fiscal ones. Supporters protest that they're just trying to facilitate choice -- even if patients opt for expensive life-prolonging care. I think they protest too much: If it's all about obviating suffering, emotional or physical, what's it doing in a measure to "bend the curve" on health-care costs?

Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren't quite "purely voluntary," as Rep. Sander M. Levin (D-Mich.) asserts. To me, "purely voluntary" means "not unless the patient requests one." Section 1233, however, lets doctors initiate the chat and gives them an incentive -- money -- to do so. Indeed, that's an incentive to insist.

Patients may refuse without penalty, but many will bow to white-coated authority. Once they're in the meeting, the bill does permit "formulation" of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would "place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign," I don't think he's being realistic.

What's more, Section 1233 dictates, at some length, the content of the consultation. The doctor "shall" discuss "advanced care planning, including key questions and considerations, important steps, and suggested people to talk to"; "an explanation of . . . living wills and durable powers of attorney, and their uses" (even though these are legal, not medical, instruments); and "a list of national and State-specific resources to assist consumers and their families." The doctor "shall" explain that Medicare pays for hospice care (hint, hint).

When in doubt, go to the primary source. I don't know if this link will still work when you read this, but go to thomas.loc.gov, and search for sec. 1123 of HR 3200, and you should be able to find it. Unfortunately, the way that "payment" is described:

(2) PAYMENT- Section 1848(j)(3) of such Act (42 U.S.C. 1395w-4(j)(3)) is amended by inserting `(2)(FF),' after `(2)(EE),'.

doesn't lend itself to easily figuring out what is going on with this. Charles Lane thinks that there is some financial incentive to encourage doctors to have these discussions, and I can't immediately tell that he's wrong. Remember: the Democrats are the party that gave us Governor Richard Lamm of Colorado, most memorable for this infamous statement, some years back, as this March 29, 1984 New York Times article reminds us:

Elderly people who are terminally ill have a ''duty to die and get out of the way'' instead of trying to prolong their lives by artificial means, Gov. Richard D. Lamm of Colorado said Tuesday.

This is a hard set of choices that people have to make--at what point do you decide to stop fighting death? In a sense, the moment any of us is born, we are "terminally ill." I assure you, I have no interest in spending six months lying in a hospital bed, withering away when I know that my time has come. I know where I'm going. But that's my choice, and that of others having to make that hard choice of when life is worth fighting for, and when it is time to pack it in. The last thing I want is the government nagging me, directly, or through its subcontractors, to hurry up, and get out of the way.

If there is anything that the totalitarians (that is to say, the left) has spent the last century doing, it is demonstrating that it believes that human dignity is worth nothing--that everything is reducible to a financial measure, and some people are worth more than others. You can see the proof of in the killing fields, in the Gulag Archipelago, in mass starvation in the Ukraine, in gas chambers, in mass graves across Eastern Europe.