A High-Profile Bioethicist!?!

What did these parents feed their children? One is White House Chief of Staff, one inspired an HBO show about Hollywood agents, and the another has become maybe the first ever famous bioethicist. 

The insanity of all of that aside, this NY Times piece on Dr. Ezekiel J. Emanuel and his role in advising President Obama's on healthcare legislation is a great read. If for no other reason, it is yet another example of how issues that need to be carefully, reasonably discussed get spun out into crazy, maddening, thoughtless rhetoric in the political arena.  

Betsy McCaughey's Daily Show Appearance

I'm posting Jon Stewart's interview with Betsy McCaughey, former Lieutenant Governor of the State of New York who is credited with starting the myth that the current healthcare reform bill will lead to senior citizens not getting medical care. In other words, she is the mother of the hysteria about elderly people being encouraged to sign DNRs even if they don't want to, being told they have to just sit back and die instead of receiving actual care. 

And according to political gossip, McCaughey inspired Sarah Palin's controversial remark about "death panels." 

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Betsy McCaughey Pt. 1
www.thedailyshow.com
Daily Show Full Episodes Political Humor Healthcare Protests

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Exclusive - Betsy McCaughey Extended Interview Pt. 1
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Daily Show Full Episodes Political Humor Healthcare Protests

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Exclusive - Betsy McCaughey Extended Interview Pt. 2
www.thedailyshow.com
Daily Show Full Episodes Political Humor Healthcare Protests

The interview shows how complicated this bill is, but also, how easy it is for it to be twisted to one person or another's purposes. Also, it's a great interview on Stewart's part, if you can stand watching a little confrontation. He does an excellent job of cutting through her double-speak and forcing her to point to exactly where the bill says what she is claiming it says. (Which by the way, it doesn't.) 

Apparently, McCaughey resigned her position on the board of directors of the Cantel Medical Corporation following this interview. 

But here's a silver lining: Maybe this hyperbolic, fear-mongering spin is finally backfiring, and now, people will actually start to really think about living wills and advance directives in a serious and calm manner. We can hope, right :)

Death with Dignity Panels

So, I've gone from thinking I wouldn't post anything on the healthcare-reform debate to posting on it twice in two days. 

The Senate has removed the portion of their bill that allows Medicare to pay doctors for counseling sessions with patients regarding advance care and end-of-life planning. (Right now, it's still in the House version of the bill.) 

Just to be clear, these counseling sessions are happening already. End-of-life planning often occurs when someone becomes terminal. Patients will sit down with their team to discuss their options for resuscitation, hospice care, pain management, comfort, etc. 

What this particular bill provision addresses is not the actual conversation but Medicare coverage of the conversation. By paying doctors for time they are now not getting paid for, they may be encouraged to hold even more end-of-life consults—thus allowing more people to openly discuss how to create the best death possible for themself, making this blogger very happy. 

And yet, proponents of it are pushing fear in our faces, speaking as though passage would magically make death come sooner. As though the government is going to be paying off doctors to tell patients it's time to go. 

The American Medical Association supports this provision. The National Hospice and Palliative Care Organization supports this provision. These are two highly reputable organizations. Plus, to insinuate that individual doctors would go against their ethical, sworn duty to "first do no harm" and actually give up on patients because they're given money from Medicare, is incredibly insulting. 

Sarah Palin has infamously gone so far as to call these "death panels," which is so absurd, I don't even know how to address the claim.

When I hear these arguments, I can't help but flash back to some of the anti–death with dignity arguments. 

One of the big arguments against death with dignity—one of the fallacy, weak arguments—is that insurance companies will use the legislation to push people into death so that they don't have to pay for continued treatment. (Remember the Martin Sheen ad?) 

Well, if you replace "insurance company" with "the government" and "death with dignity" with "healthcare reform," this is basically the same argument being paraphrased and reshot at us. 

It's inaccurate, and it's fear-based, and it's a shame that it looks like it might pull the public away from more information and better choices. 

Take a Pain Pill

Hospice Blog has an excellent post today about President Obama use of the term "end-of-life care." 

The Hospice Guy has noticed that Obama uses end-of-life care to refer to the elderly simply seeking healthcare, instead of differentiating between people who are actually in their last days, needing care that will take them through to their death. And in so doing, he worries that Obama is confusing the intent of hospice as a place where people can go to die in peace and as much comfort as possible once they have CHOSEN to die. 

As the Hospice Blog points out, Obama's use of the term is almost a window into how little he really knows about the day-to-day realities of the medical world. And whether you're for or against public healthcare, it's a little scary to think of anything but the utmost experts revising our healthcare system. Here's the video he shares.

(Please note: the title of this YouTube film is misleading. Obama is, of course, not that dismissive to the woman.) 

The woman asked if her mother, at 99, could have had a pacemaker under public healthcare, even though she was old because she had much higher than normal quality of life. I think the bigger question she was getting at was, what if it looks bad on paper, but when you see the patient in person, you can understand where a procedure makes sense—hence the reason she says, "A picture is worth a thousand words." And Obama's answer is disappointingly to infer that the surgery was not going to help (even though it did) and to tell her mother to take a pain pill!? 

He's telling her, no, right? I've watched this about five times trying to get through the political speak, but that's what's happening here, I think. He's saying, no, in essence, that the bigger concern is trimming the waste from the healthcare system and her individual mother matters less? Other interpretations? 

I love that people are discussing healthcare in such a high-profile way right now—especially when it comes to end-of-life matters like resource allocation in the last years, what constitutes quality of life that is good enough, etc. But I hate that the discussion is being handled with such vitriol. And I hate even more that a bunch of politicians, mostly constitutional lawyers, with voters and elections on their minds are going to decide how healthcare issues should be managed. 

I hope the legislators are consulting some good healthcare professionals behind the scenes. 

And just like that, I'm a Robert Gates fan ...

For me, proof that even in the most stressful times, life is still full of happy surprises.

Defense Secretary Robert Gates has reversed the policy that forbid press coverage of flag-draped caskets carrying the remains of fallen U.S. soldiers coming into Dover Air Force Base in Delaware.

The decision will now be left up to individual families whether to allow media access to each homecoming.

If draping a flag over the casket is not meant to be a visual symbol, then why do it? And if it is a visual symbol, why are we afraid for people to see it? And if the family of the fallen wants to share it with the world, why shouldn't they be able to as part of their efforts to fully honor their family member?

The policy was first put in place in 1991 by George H.W. Bush, and this time around has been in effect since 2001. (I believe President Clinton put a hold on the regulation when he was in office, but I'll have to double check on that.)

Anyway, as they say on one of my favorite blogs, Shakespeare's Sister, taking one little teaspoon out of the sea of injustice.

Photo from ABC News.

Roland Burris Erects Mausoleum with His Qualifications

Roland Burris has erected a mausoleum in a Chicago cemetery that lists his accomplishments and qualifications for the office of senator. WTF?

I think he has his symbolism confused.

He seems to have wanted to put out his resume in a way that would grab great attention and show that he was grand. By using the stone and building a big structure, maybe he thought he was building something like a statue—monuments often built to great figures in society. But great figures do not build statues to themselves. And their accomplishments are not literally listed out on those statues.

He has greatly confused matters by putting this thing in a cemetery. Is he suggesting that it will one day serve as the mark of his entire life, and he will add to it the remainder of his accomplishments? Even if that is the case, building it now, in the middle of a media controversy over his senate seat, makes it look like an argument for his ability to serve.

It seems the use of a cemetery was merely accidental, as if it was the only place he could get land. Because, what public park would house this thing? I feel sorry for the friends and family of people who are actually resting in this cemetery.

Roland Burris sure seems like a piece of work.

(image from CNN)

Update: I've done some more research, and it appears Burris has had this monument for awhile; it's just getting lots of attention now because of him being at the center of a controversy. I'm a little disappointed that media outlets aren't making that more clear in their reporting. It seems to be a big distinction.

Anyway, the monument is certainly a reflection of a large ego ... but at least it wasn't done as an argument for his senatorship. And hey, he's making some plans for his death—which is more than a lot of people can say.

Obama's visit to ailing grandmother

I dabbled in political work in college and shortly after—some campaigns, time with training institutes. It wasn't for me. And as a result of that experience, I'm fairly cynical about politics, especially the mechanisms of a campaign and what they can pressure people to do ... but this was a profoundly classy and decent thing to do. I am surprised and impressed.