“Death panels”

Sarah Palin introduced that term into public and political debate over health care reform and now it’s regularly repeated by news analysts, usually scorned but occasionally affirmed.

Let’s look into this…

Last year, the Heritage Foundation’s director of health policy studies Bob Moffitt was on ‘America’s Lifeline’ and, with thorough knowledge of this administration’s plans to overhaul the system, Moffitt pointed out that the ‘federal council for comparative effectiveness’ was going to turn into a health care rationing authority that would, in fact, seriously threaten the lives of the most impaired and vulnerable citizens.

USA Today ran this article recently on hospital ethics panels to demystify the scary factor of such panels and explain their significant role in helping patients and families make treatment decisions when facing end of life circumstances.

Medical and moral decisions must be made. But there’s no written directive for guidance. Family and physicians disagree. What now?

Every day, in a hospital somewhere in the USA, a group of strangers — the hospital ethics committee — is called in to help people make the choices of a lifetime. 

It does a pretty good job of representing the care hospitals are giving that particular service, how complex end-of-life care is and how seriously these professionals take their responsibilities to patients and families.

“Culture and religion inform every decision about health, illness, disease and care, about true caring, about who can live, about the measure of quality in a life, about when suffering begins and how it ends. We bring our full selves to every bedside,” says Dawn Seery, head of the five-hospital Methodist Healthcare System’s bioethics committee in San Antonio…

In general, Catholic hospitals follow the ethical and religious directives spelled out by the U.S. Conference of Catholic Bishops. Other hospitals, even if their foundations were originally Baptist, Jewish or Methodist, may not answer to any one religion’s doctrines. Like public hospitals, they typically operate with a secular bioethical approach, which emphasizes patients’ autonomy and each family’s own values.

And the sticking points are almost never cost or insurance.

Stop there. This is where the discussion is about to turn, and why people are so concerned about what’s coming next. As it has stood, medical care has by and large been following the constructs described in this article. But new realities will replace what we’ve known to be health care delivery and they’ll require new criteria for new panels to make decisions on end of life care.

My nurse/bioethicist friend Nancy Valko sent along her own comments on this USA Today story and the heart of the matter.

Having served on ethics committees in the past, I can attest that the term “death panels” is not a stretch. But having a government entity deciding what to fund and threatening the conscience rights of doctors and nurses-on top of 3 states with assisted suicide laws and “futility” laws overriding patient or family choice-and you have an even greater disaster. The Terri Schiavos of this world (and others) won’t stand a chance.