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Death Panels? No! But There Are No Death Panels

posted by Brad Hirschfield

Whoever coined the phrase “end-of-life counseling”, the term used in current healthcare reform legislation, made a terrible mistake both from a marketing perspective, and far more importantly, from an ethical/spiritual one. By ceding values-based language to their opposition, and failing to approach this issue from a values-driven perspective, they opened themselves, and all those who support this much-needed aspect of health care reform, to the death panel crowd and their charge that such counseling is about nothing more than cost-cutting. Nothing could be further from the truth.
While we may not all agree about the circumstances under which medical care should move from therapeutic to palliative, or from palliative to passive, it is always a dignity and compassion issue and we would have been better served had it been called dignity and compassion counseling, for that reason.
Such counseling, which would be offered, not imposed, under the proposed reform legislation would be a godsend for many people who find themselves in need of such expertise and unable to access it when they need it most. And let’s be clear about the fact that such conversations are happening anyway as more and more people have to make actual decisions about the end of their own lives an the end of those they love.
Death doesn’t just “happen” as much as it used to, especially for those who have access to the latest medical technologies and interventions. And so, much as we may hate it, choices must be made.


That’s not a rationing issue, that’s a taking charge of your own life issue. Until relatively recently, such choices were few and far between. Now however, we often have the technological capacity which demands that we make such choices, and simply knowing that we can do something doesn’t necessary mean we should do it.
We need to distinguish the difference between having the knowledge/capacity to do something and possessing the wisdom to determine whether or not we should. Compassion counseling, end-of-life counseling –call it what you will, simply invites us to be better informed about that kind of complex question.
If people find that threatening, it is either because they have never faced those painful questions personally, or can not rest until all people are forced to make the same decision they would under similar circumstances. Where is the dignity of life in that kind of thinking?



  • http://wildernessinthecity.blogspot.com/ bill holston

    Completely agree Rabbi.
    My 86 year old Father died in April. The doctors were of no benefit, talking about pacemakers for a man in end stage cardiac failure.
    I’d be pleased to see medical professionals or someone spending more time and energy helping families with these excruciating decisions.

  • Patsy Elders/Norman, Ok

    I would love to have this discussion with my doctor at the VA (and plan to as soon as I can). I would never want my children (nor the government as in the case of Terry Schiavo) to make the decision for me. I blame the Republicans for the mess we keep getting in and I thank the Democrats for caring enough about ALL of God’s children, to give medical care to all citizens.

  • Doug from PA

    Both Rabbi Hirschfeld’s and Ms. Elders’s comments are simply wrong. It is quite clear from the legislation that passed the House and, more important, from the history of socialized medicine in the UK and Canada that “death panels” is a reasonable interpretation. Look at Obama’s response to a woman who asked whether her mother would still have gotten advanced treatment under Obamacare. His response: maybe just giving pain medicine would be better. This is necessarily true under any govt.-controlled system. Whoever pays the fiddler calls the tune.
    As for Ms. Elders, I would ask you where in the Constitution the govt. is given the power to take money from some people in order to pay for the health insurance for others. To argue that the Dems want to help people and to blame just the Reps for our health care mess is just partisan babbling.

  • Your Name

    Partisan babbling? What kind of mentality is so totally selfish and short-sghted that it can’t (refuses to) understand the need for all citizens to have adequate health insurance? (This is of course a current symptom of our society’s disintegration: we are all isolated (boot-strapping, don’t you know) and no longer part of an extended community (formerly Civics 101 in any 9th grade classroom, now known as “socialism” to republicans of the religious right). Adeqate health insurance reinforces the public good by maintining the public health. Anyone with the most remote understanding of epidemiology understands the principle that when you’re sick and can’t afford NOT to spread it (no insurance, no sick time, no steady income) you’re substantially increasing the likelihood that your sickness will spread into the community at large. Learn to think for yourselves, folks,and stop making a career out of never thinking things through.

  • Zvi I Weiss

    To “Doug from PA”
    It seems clear from your last paragraph that
    “death panels” is not your issue at all –
    You apparently feel that there is no “mandate”
    or responsibility to provide health care for those
    unable to afford it.
    You are certainly entitled to that opinion but
    I would like ot point out that the perspective
    of “what is mine is mine and what is yours is yours”
    and not really caring about others is described as
    the personality trait of those who lived in Sodom.
    In other words, the people of Sodom were noted for
    cruelty BASED UPON that they did not care for anyone
    except “each man for himself”.
    As for Obama’s answer (which just MIGHT be taken out of
    context) — just MAYBE it is the correct one. Not because
    of “Rationing” or “Socialized Medicine” but because of the
    specific circumstances.
    I have seen reports that the “public option” (if it is
    adopted) would cover no more than 5% of the population.
    On the other hand, WITHOUT the “public option”, how do YOU
    intend to control the for-profit insurance companies
    who ALREADY impose “Rationing” every time they deny a claim
    for [supposedly] “experimental” treatment or set a “usual and customary”
    rate that is utterly laughable. The for-profit insurance companies
    try to force users to “network” doctors often by offering “non-network”
    doctors idiotically small fees.
    But, of course, if YOU have good “company provided” insurance
    then it does not matter what happens to or with anyone else –
    and this is EXACTLY the characteristic of Sodom that I described above.
    Instead of trotting out “Canada” or “England” as the bad boys of
    “Socialized Medicine” or making comments about “who calls the tune”,
    have you looked at France or Switzerland
    or Israel? In those countries there is good basic “universal care”
    – not perfect but arguably FAR better than what we have here. [the
    last time I was in Israel, people were horrified by the description of the
    CURRENT Medical coverage here.]
    Finally, if you are so opposed to the “government option”, why not
    simply push for the abolition of “for-profit” health insurance replaced
    with non-profit organizations? I am sure that you are aware that organizations
    such as Kaiser Permanente (on the West Coast) consistently score very highly in the
    provision of health care. In Israel, the “Health Insurance” is provided by Non-Profit
    gropus who compete with each other. Health insurance in Israel is NOT a political issue
    – virtually all are pretty satisfied and you do NOT have “long lines”…
    So, instead of excoriating Obama’s attempts at Health Insurance reform, maybe
    you should look beyond your personal “needs”….

  • Your name # 2

    Hey “Your Name” take a chill pill and settle petal.
    Doug from PA has a very legitimate point and you dove down his throat.
    It’s a “discussion” website….so take it easy. :)
    The democrats only do something to make themselves look good.
    I don’t trust them as far as I can kick them.
    I also don’t trust that snake in the WH either, so don’t attack me.
    Opinions are like noses…everyone has one.
    Cheers.

  • Your Name

    Dear Your Name #2,
    “Take a chill pill and settle” isn’t a phrase in any English lexicon; further, my opinion is based on my own graduate studies in epidemiology at a large midqwestern university. Until you have a dctorate in Public Health, I suggest that you swallow whatever pill might be necessary to stifle your ignorant remarks.

  • http://www.newsavedavid.com David

    Rabbi, thanks for clarifying this, but why did you wait so long?

  • ralph

    some of my objections are:
    1) being told you MUST buy medical insurance, “or else”
    2) government getting too involved in the private sector
    3) another step toward socialism…(Hugo Chavez would be proud)

  • Josh

    My thoughts on Ralph’s comments:
    1. So you stopped driving when the government mandated car insurance?
    2. So you don’t want medicare, and you think it’s ok for old people to pay up or die?
    3. Socialism? This isn’t socialism. This isn’t even Health Care reform; it’s HEALTH INSURANCE REFORM. Please take a few minutes to go through the slideshare.net presentation cited above. Dan Roan does a terrific job of framing the debate. Simply put, doctors/hospitals and insurance companies are fighting over our healthcare DOLLARS, not our healthcare.
    BTW, we can destroy Hugo Chavez as well as the other petro-funded scum on the planet by reducing our addiction to oil.

  • Patsy Elders/ Norman, OK

    Doug, I do hope you get to see this! Do you want to discuss taking money from some to help others. Can we say FEMA and flood insurance? My taxes go to cover help for those that have repeatedly built in flood/hurricane zones, as on the expensive beaches! They get government help and MY tax dollars pay for it! And I am a veteran and have the right to believe any way I want. I would like for you to gracefully decline Medicare as the “bleeding heart liberals,yes I am one” passed this single payer system that was called socialized medicine by Reagan, Rumsfeld and others and said it would never work and we should NOT be taking money from some to help others. So DO NOT accept it! Check it out Doug!
    MEDICARE AND SOCIALIZED MEDICINE DEBATE
    In 1945 Harry Truman (Dem) sends a message to Congress asking for legislation establishing a national health insurance plan.
    Two decades of debate ensue, with opponents warning of the dangers of “socialized medicine.”
    By the end of Truman’s administration, he had backed off from a plan for universal coverage, but administrators in the Social Security system and others had begun to focus on the idea of a program aimed at insuring Social Security beneficiaries.
    Medicare, a single payer system was passed July 30. 1965 by Lyndon B. Johnson (Dem), but some Republicans voted against it.
    Those who voted against the historic legislation that has meant so much to the security of our senior citizens. The list, as you might expect, speaks volumes.
    Ronald Reagan: “[I]f you don’t [stop Medicare] and I don’t do it, one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” [1961]
    George H.W. Bush: Described Medicare in 1964 as “socialized medicine.” [1964]
    Barry Goldwater: “Having given our pensioners their medical care in kind, why not food baskets, why not public housing accommodations, why not vacation resorts, why not a ration of cigarettes for those who smoke and of beer for those who drink.” [1964]
    Bob Dole: In 1996, while running for the Presidency, Dole openly bragged that he was one of 12 House members who voted against creating Medicare in 1965. “I was there, fighting the fight, voting against Medicare . . . Because we knew it would’t work in 1965.” [1965]
    Also Gerald Ford, Strom Thurmond, and Donald Rumsfeld.
    Sources
    http://www.seniorjournal.com/NEWS/2000%20Files/Aug%2000/FTR-08-04-00MedCarHistry.htm
    http://trueslant.com/rickungar/2009/07/29/look-who-voted-against-medicare
    Patsy Elders Norman, Oklahoma
    and a Rep from Ok is holding up care for the veterans, but readily sent them off to war!! And I have MUCH more than this!!
    DID YOU SERVE?
    And Doug and others against this, look in the face of your mother, daughter, son or wife and say, our insurance just got cancelled and now you will die! Did you know the insurance companies say a woman beat in a domestic violence incident has a pre-existing condition? And FYI–the holes in Jesus’s hands would be considered pre-existing!
    I hope you NEVER have to watch your child suffer like I have due to lack of insurance, may the compassionate Dems pass this so you can sneak in the back door of the doctors for care (paid for by us)

  • Your Name

    Josh got it dead on (no pun intended.) The issue of health care reform has gotten so bogged down in misinterpretations and outright lies that the American public is suffering a mass hysterical reaction to any form of change whatsoever. AARP.com has the straight scoop on what is happening as well. As for end of life planning–we nurses have been using that term for years when counseling patients on protecting their interests when faced with a critical illness that may or may not result in passing. Who makes the decisions if a patient cannot? How much treatment does the patient want when faced with a terminal condition. Those are the questions patients need to ask themselves when thinking of Living Wills and Durable Powers of Attorneys. Talk to your families, your friends, and tell them what you want, and then put it into legal writing. That’s what end of life planning is all about.

  • Your Name

    When I get dumped off my insurance because the company I work for will save money by paying an 8% of payroll fine instead of paying my health insurance and then the gov’t plan doesn’t use my Doc or hospital and they assign me a new Doctor that the Gov’t plan is then paying to see me and then that Doctor is mandated by it’s employer(the Gov’t) to discuss end of life options with me in order for them to be paid, I call that a death panel!! People wake up!!! We do not need more Gov’t we need less. The Gov’t has created the mess we have with insurance as it is. The gov’t is the one regulating it now. Medicare denies a lot more claims then any private insurance co.’s look it up. All of us with private insurance will end up in the gov’t plan if one is allowed to be enacted. The gov’t is setting it up so that it will be the best option for employers to drop your coverage. Just like the original fines for not having insurance were so high that most would comply but now they have lowered them but yet still insist that the insurance co.’s must insure you with pre existing condition’s,, thats like never paying homeowners insurance until the house catches on fire and the insurance co. being forced to cover your lose. If the true goal was to cover the working poor they could just up the minimum income requirements toqualify for medicaid. No one is turned away for care at hospitals and I have never had a Doc. refuse to see me when I asked about making partial payments at the times when I haven’t had coverage.

  • Your Name

    Your plan can stop paying your doctor at any time and you will have to pay yourself or find another. Why do people think our current insurance coverage doesn’t do this? I have insurance through my employer and neither my husband or me can see the doctor of our choice.
    All of these people who are so against any govenment involvement should refuse Social Security, Medicare when they are old, education for their children unless they pay for it themselves, etc. Republicans don’t trust government to take care of health care…well I don’t trust big business to do it because they have never strived for anything but maximizing profit…which is why it costs so much and so many claims and people are denied.

  • Rhonda

    If you don’t trust big business then you need to look into who is behind Obama’s healthcare plan. I have asked everyone I know if they know anyone first hand that has been dropped by their private insurance co. or refused treatment and only one person has been told they couldn’t use the facility they wanted for cancer treatments and they are on medicaid. I had breast cancer and was never refused treatment or canceled. Most employee insurance plans are chosen by the employee from a menu of choices. Name one thing the gov’t runs efficiently? Everything they run is going bankrupt. As far as turning down SSI or medicare I have been paying taxes into those for 30 years and guess what I won’t have to turn it down it just won’t be there. They are running them dry!!! They have had their hands in our money spending it on what they want and now that they are out of our money they want to get their hands on more of our money!!
    NO THANKS

  • Rhonda

    The dems,,, the far left ones that were going to vote for the healthcare bill without the Stupak ammendment are pro abortion,,I hardly would call that caring for all of God’s children. As far as the elder man not needing the pace maker because of advanced cardiac problems and his age,,perhaps if the doc didn’t have to worry about being sued if an 86 yr old man died of cardiac problems “because he didn’t put in a pacemaker” the doctor probably wouldn’t have offered it. Read the Your Life Your Choices veterans book pg 21.

  • Your Name

    They already have the death panel in place. They passed it in the 787billion stem package. They have already installed the 15 people to check your medical records to see if you need the medical procedure or not.

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