The Death Book for Veterans
August 20, 2009 posted by John Allen · 27 Comments
Ex-soldiers don’t need to be told they’re a burden to society.
by Jim Towey
If President Obama wants to better understand why America’s discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Department of Veterans Affairs (VA). He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.
Last year, bureaucrats at the VA’s National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA’s preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."
Who is the primary author of this workbook? 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.
"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").
This hurry-up-and-die message is clear and unconscionable. Worse, a July 2009 VA directive instructs its primary care physicians to raise advance care planning with all VA patients and to refer them to "Your Life, Your Choices." Not just those of advanced age and debilitated condition—all patients. America’s 24 million veterans deserve better.
Many years ago I created an advance care planning document called "Five Wishes" that is today the most widely used living will in America, with 13 million copies in national circulation. Unlike the VA’s document, this one does not contain the standard bias to withdraw or withhold medical care. It meets the legal requirements of at least 43 states, and it runs exactly 12 pages.
After a decade of observing end-of-life discussions, I can attest to the great fear that many patients have, particularly those with few family members and financial resources. I lived and worked in an AIDS home in the mid-1980s and saw first-hand how the dying wanted more than health care—they wanted someone to care.
If President Obama is sincere in stating that he is not trying to cut costs by pressuring the disabled to forgo critical care, one good way to show that commitment is to walk two blocks from the Oval Office and pull the plug on "Your Life, Your Choices." He should make sure in the future that VA decisions are guided by values that treat the lives of our veterans as gifts, not burdens.
Mr. Towey, president of Saint Vincent College, was director of the White House Office of Faith-Based Initiatives (2002-2006) and founder of the nonprofit Aging with Dignity.
This is utter hokum.
Our author takes one issue he enjoys, a religious one, spins it and ignores every other veterans health care abuse.
screw this asshole.
g
Your comment is narrow minded. This is the greatest “veterans health care abuse”. Watch the movie “Logans Run” to see how compasionate convincing leads to society’s solution when you (the individual) are deemed no longer benificial to it.
Which “asshole” will you screw when they introduce the “Obama drip” in your viens to hasten your journey to Carasel (Logan Run reference)?
I fought for freedom, not right of the government to kill me as soon as they deem me a non-productive Lemming.
Get onboard to save your life or just take the drip now!
g, I agree with you. It is full of “fear, fear, fear.” This is a tactic Bush/Cheney utilized to control media spin, and if you also notice, the author worked under Bush so is well trained in that strategy. I am disappointed that Veterans Today ran this, as it is not based on truth, but religious conclusions. Veterans need the truth and can match up their beliefs however they choose.
Hey Duffster, anyone who does not agree with your liberal left wing pinko comments is an asshole”. What does that make you, the ass?
From what I understand, the faith based initiative people were among the first to get grant money to go out and harass, stalk, and slander people at the behest of the DHS. But that goes back to about 2003, so we can assume an entire cottage industry has grown up around getting grant money to snitch. All in secret of course. Id have to agree to give this guy the heave ho because he was most likely all for this sort of faggotry while bush was in office, but is now getting cold feet because obama is pulling the strings. How that old republic joke go? Its not fascism if WE are doing it?
One author takes one issue…spins it…? What a narrow-minded view! This author simply reported on a newsworthy event, and then commented on how he feels it is a disservice to our veterans. I will refrain from using vulgarities to describe you – and other godless, anti-religion mental cases. May I presume that you would prefer to be “guided” to euthanasia when you get old and “less productive”? You must be a very unhappy person. I feel sorry for you.
b cvnv
Why do people always feel the need to make issues personal when they don’t agree with the author. What happened to respect for opinion. I believe when u stoop to the personal level u lose the arguement. The author dealt with fact. The book does exist and is promoted. Now whether u like it or not accept the truth and then decide if u approve of it or not. It is time for America to grow up and act like adults. Look at facts and make a decision. Just stand for something. Character not comments. The people want truth.
Actually, this article is not entirely truthful. I have read the document the author refers to and, as a daughter whose mother died from a terminal illness, found that the information contained would have been VERY helpful in making decisions for her care before she died. You can download your very own copy of “Your Life, Your Choices” at http://www1.va.gov/pugetsound/docs/ylyc.pdf
I am so tired of people who keep repeating and passing along the same old talking points without doing their homework. All this article serves to do is create fear instead of rational conversation around the real issues.
Well-done and well-said, Amy!
Your comments are well put. All doctors and hospitals are giving people booklets on “health care decisions” but don’t provide any guidance on how to make and write these decisions down. Just like all the scare tactics used with the health care reform bill (which I am against) about the few lines authorizing payment for counseling on making these decisions, people need to read the actual article or bill and make up there own mind. My husband and I have Health care decisions (not a living will – you don’t need a will if you are living) that we had a very hard time stating what we wanted. We would have loved some help on wording this.
And thanks for the web site I could not find it.
Respect for the Author? and it being the truth?
Who says so? I have not been bothered by the VA for my death wish, have been advise about having a will and stuff like that, but my civilian doc says the same thing.
Just more psych crap – welcome to NAZI Germany in the Land of Freedom
CHOICES my foot – live life enjoy life or endure life – - Euhanasia is what it
is is murder or suicide – not a survival thing for anyone or any society.
scrap the psych crap. Land lets live – enoy – endure.
Bente Petersen
Just more psych crap – welcome to NAZI Germany in the Land of Freedom
CHOICES my foot – live life enjoy life or endure life – - Euthanasia is what it
is is murder or suicide – not a survival thing for anyone or any society.
scrap the psych crap. Land lets live – enoy – endure.
Bente Petersen
Good Evening Folks,
I’m in agreement with Duff on this one but most likely for different reasons. Having been and still am a patient in the VA Healthcare System, since 1967 I have seen the document spoken of as well as several others that came before it, that deal with choices for end of life care.
A Veteran has the option of not filling out any of these documents that are referred to as “Living Wills”, and will get the standard, heroic efforts treatment at the end, the tubes, hoses, wires, needles the whole nine yards. But if this is not your choice of how you want to exit the world you are offered to express your desires, four choices not offered are assisted suicide, suicide, euthanasia or when to terminate treatment.
“Your life, your choice” is a reasonable document that deals with such factors as religious preferences, how the patient wants to have it at the end such as to be at home, in a limited care facility or what ever choice the Veteran may want, there is no list to chose from. Ideally this process is done when the patient enters the system and is reviewed periodically.
The only “Death Panel” is yourself. It is a very sad day when radical right wing politicos make a political pi**ing contest out of such a personal and basic decision.
ALLONS,
Byron Skinner
As a Veteran I find this document offensive and impractical. Why make a Veteran feel useless and a burden to society and family. You are ready to blame the right wing. This argument is getting old. Do you know that the doctor who wrote that document is for assisted suicide. What a coincidence.
This is my second request to be removed from your email listing…Your story is so off the wall, and you’re doing a disservice to all concerned. Get your facts together…getting information on the decussions that need to be made before your death is a good thing. You draw the wrong picture and you know it.
Seems the above author is a part of the new spin trying to frighten the flock into screaming about anything they can find to justify their twisted wants, gee sounds like the many excuses used to justify the killing and destruction in Iraq. I’ve now seen this printed out in a number of online sights and offline so called conservative periodicals, it’s a concerted effort, either this clown is a part of it or just got used by his herders!!
You frankly are an irresponsible adult if you don’t research a living will, your choice in whether you sign one, and thinking what an extension of your life, via drugs and tubes and unconcious, will do not only for the quality of life but as to your family!
But the sheep seem worried, as they don’t think for themselves now, that some boogeyman will decide their fate, Oh Wait they already do, It’s Called Denial Of Service By The Insurance Companies, After Paying For years The Premiums, So The Investors And Execs Can Keep Them Profits Up!!!!!!!!!!!!!
another act against health care reform
Why is there a book like this? The VA’s job, is to help vet’s make the best of there lives to provide the resources of a grateful nation. The socialist’s in government want to save money by getting those who have suffered for this nation to give up their lives and reduce VA costs so the money can be given to Acorn to buy more Democrat votes. To those who have lived, they all know dieing is easy. You don’t need a book to help it along.
The author has done his job well, divide the veterans and get them distracted from the real cause, namely reform of the VA system. It never worked for the veteran only against them. By sturring up hate and getting us un-united to take action the arthur has done us all a diservice. KEEP YOuR EYE ON THE BALL, push evrey VA offical and congressman to reform the VA for real. Good luck all and don’t give this article much attention.
http://img259.imageshack.us/img259/576/weethepeople.jpg
Interestingly, I went to the SOURCE Document (not the “source” story, which this item is a derivative of), and a disclaimer at the top states “Your Life Your Choices: Planning ofr Future Medical Decisions” is a 1997 publicatin and is currently under revision.” See: http://www.ethics.va.gov/YLYC/YLYC_First_edition_20001001.pdf
May I ask, where was Obama in 1997? Was he president? No? Oh gee, then why is he being blamed for this?
By the way, isn’t it a LAW that all hospitals have to supply patients with information like this?
And, like a previous writer commented, there is no compulsion in this: just read it, trash it, use it or pass it on. The VA can’t make you do anything…heck, isn’t this the same writer that complains about how ineffective the VA is!
In 1997, the VA had the 52-page end-of-life manual, “Your Life, Your Choices.” This planning manual appeared to assist our vets in preparing a living will. It became clear to the Bush administration that it was being utilized for nefarious reasons and its use was suspended. The Obama administration reinstated the end of life manual.
There’s your answer!
This only looks like another avenue for the fear mongers to scare people about Obama. Pretty sad I would say.
I’ve read the entire document at http://www.ethics.va.gov/YLYC/YLYC_First_edition_20001001.pdf, since I wasn’t able to access the one listed in an earlier post. It is a document that I deem would help anybody now, while they are healthy and if/when their health changes, to make it known to family, friends and health care providers what your wishes are regarding your last days on this earth. I didn’t see anything in it related to assisted suicide. Duffster, Skinner I agree with you two.
I think everyone should download “Your Life, Your Choices” and implement it. This is a well written workbook that will help you think about what you want and don’t want if and when you get into a situation where you cannot speak for yourself.
I would think that any responsible person would want their physician, family, friends and clergy to know what to do if they could no longer convey their wishes to their caregivers. I have been working in the health care field for over twelve years and have seen more families than I care to remember anguish over these matters. If their loved one had made these decisions in advance, the choices would have been clear as to what was the right thing to do. Namely, carry out the debilitated person’s wishes.
It is discouraging when I see so many people simply believing what they see on TV or read on someone’s blog when they should be going to the source and reading the information themselves. Read the document and make your own decision. You can find it here: http://www.ethics.va.gov/YLYC/YLYC_First_edition_20001001.pdf