“End-of-Life Consultation” Provision Being Implemented By U.S. Health & Human Services

By Daniel Downs

The LifeTree organization recently reported the U.S. Department of Health was implementing “death panels” measures under then newly passed Obamacare. The infamous Section 1233 of HR 3200 would have federalized voluntary end-of-life consultations, but the section was eventually dropped.

On 29 November, however, the Federal Register (page 73406) published a funding new rule for “voluntary” advance care planning consultations for Medicare and Medicaid patients.

A very enlightening analogy is LifeTree’s equivalence of the new regulation to so-called voluntary TSA pat-downs and full-body scans. It is like a thief asking you for money while pointing a gun at your head.

Some are trouble by the media’s failure to report the new ruling. However, silence of the part of the media is probably due to it similarity to current policy.

When my parent was in hospital, we were asked about living will. We were given information about making plans for emergencies and end-of-lie decisions.

LifeTree researchers are more concerned about the implementation of the other part of the original end-of-life consultation legislation that is already making its ways through Congress. The bill is called the “Advance Planning and Compassionate Care Act of 2009.” It was introduced by Democrats Earl Blaumer (OR) and David Rockefeller (WV) both proponents of assisted suicide. Blaumer is also an advocate of the health care rationing groups and process known as “Physician’s Orders for Life Sustaining Treatment” (POLST).

As explained by Ione Whitlock, POLST is similar to the current document based directive (living will) through which a person’s medical treatment preferences are stated and honored. Under POLST, the document serves the medical process of repetitive questioning by various health care givers. The process is rigged to pressure the patient and/or family toward accepting medical ethics committees’ goals. Those goals advance their policy about advanced illness and conditions as well as reducing inappropriate treatments (often life sustaining treatments).

Recent experience with my parent’s medical care seemed a lot like POLST. The seemingly endless questionnaires by all kinds of nurses, doctors, therapists, and other specialists were numbing. Each new treatment by a different specialist and each new place of care (even in the same hospital) were met with the same series of questions. The same things were asked over and over. What I’m not certain of is whether the goal was get us to accept a predetermined series of treatments–maybe in part. Maybe, it is a conditioning process for greater acceptance of the POLST legislation.

The bioethicists who devised the POLST Paradigm hyped the documents’ use as tools for dignity and autonomy. The documents do leave the door wide open to an “autonomous” decision to hasten death. Yet, POLST owes its existence more to Oregon’s experiment with health care rationing than it does to the state’s assisted suicide experiment, according to Whitlock.

Do you remember how Terri Shiavo’s life was ended by removing her feeding tube? That is the ultimate health care rationing measure under POLST.

The bottom-line is POLST facilitates not only assisted suicide but also imposed death. “It is also an effective cost containment device. It creates an illusion of ‘self-determination’ while fostering consensus ethics. In short, the POLST process rigs the system in favor of pressuring the patient and family [to choose death].”

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