Saturday, August 15, 2009

Medical Experts Respond to "Death Panel" Deception

For the last two weeks, Sarah Palin has been acting like a creepy version of Dr. Quinn Medicine Woman, with her creepier sidekick Senator Charles Grassley. The two have repeatedly stated that the proposed healthcare legislation would create "death panels" to decide whether patients could live or die.

Many commentators have debunked the horrible distortion (see, e.g., here) and have exposed the hypocrisy of Palin and Grassley on this issue. Nevertheless, the fearless and factless duo continue their assault on the truth.

Palin -- obviously believing that adding footnotes to a lie transforms it into the truth -- released yet another Facebook statement on the perils of liberal death squads. And Grassley invoked the image of the government pulling "the plug on grandma" in order to scare constituents into believing his deceit.

Two Medical Experts Rebut Palin and Grassley
CNN has published a very thoughtful essay written by two medical experts who, based on their area of expertise, probably have a lot of experience with patients who could benefit from end-of-life counseling. Douglas W. Blayney, MD and Brenda Nevidjon, RN have authored an op-ed for CNN that rebuts conservative distortion of the legislation and that explains why the provision would advance patient care.

Blayney "is president of the American Society of Clinical Oncology and professor of internal medicine at the University of Michigan. He specializes in the treatment of breast cancer and lymphoma and was in private practice for 17 years in California." Nevidjon "is president of the Oncology Nursing Society and clinical professor of nursing at Duke University School of Nursing. She was the first nurse and first woman to be chief operating officer of Duke University Hospital."

Responding to the Deception
Blayney and Nevidjon argue that the conservative depiction of the provision is "completely false":
This provision simply provides for Medicare to pay for voluntary conversations between patients and their health care practitioners on the difficult but important subject of planning for care at the end of life.

The provision is purely optional, and patients would be able to choose whether to discuss the issue with their practitioners. For those who decide to do so, there would be clear benefits.
Medical Benefits of End-of-Life Counseling
Blayney and Nevidjon also discuss the medical benefits of having advanced end-of-life counseling -- something critics of the healthcare proposal universally ignore. This type of counseling, as the American Medical Association has concluded (see AMA policy E225), can ensure that end-of-life treatment will reflect the patient's intent:
We discuss end-of-life care with patients to fulfill our commitment to them throughout the course of their care. When a disease cannot be cured, we can assure our patients that we can make them comfortable in their last days. When these conversations are done in advance and done well, everyone benefits -- patients, families and all members of our care teams.

As practitioners, we know from experience that discussions with patients in the end stages of their cancers and with their family members may be long and emotional, but ultimately lead to end-of-life care centered on the patient's wishes. We have seen many patients who were well-cared-for by their families, with professional help, and were comfortable in their surroundings.
Rebutting Palin and Grassley's lies has wasted precious time and energy. There are many aspects of the proposed legislation that warrant debate. Palin and Grassley have disserved the public with their intentional distortion of the proposed healthcare legislation.


Mike Licht said...

Dr. Ezekiel Emanuel hasn't told OMB anything about Advance Care Planning that Newt Gingrich hasn't proposed himself.


desmoinesdem said...

Saw your guest post at Salon, titled Palin and Grassley, Dumb and Dumber. It brought me back to the early 1980s, when Iowa's senators Roger Jepsen and Grassley were known as "dumb and dumber" until Harkin defeated Jepsen in 1984. Yes, you had to be dumb to lose your Senate seat the year Reagan carried Iowa 59-40.

Unfortunately, Grassley is not dumb--he is smart and he is playing the White House for fools. Either that or the White House is using the bipartisan negotiations as cover for giving away the store to corporate interests, in which case we are being played for fools.

Darren Lenard Hutchinson said...

Desmoinesdem: Thanks for that piece of Iowa political history. I think you are right about the White House -- they are either inept on this issue or they are in with corporate America. Maybe a little of both? Obama does not want to come across too hardline because he has to cater to corporate America and moderates in Congress. By playing stealth, however, he allows opponents of healthcare to shape the dialogue.

Darren Lenard Hutchinson said...

Mike: I saw that story this morning. The hypocrisy is becoming too thick to follow.

FLRN said...

Darren - Thank you for taking the time to seek out discussion and dialogue from medical professionals on this crucial issue. The Critical Care nurses, Emergency Nurses Association and countless other groups that deal with delicate the end-of life counseling all recognize this portion of the proposal may well be the most sensible aspect of the legislation.

As a healthcare professional I am a bit perplexed why this much needed educational piece is under attack rather than the obvious deficiencies such as the eligibility criteria and services eclipsed by bureaucracy?

Here are a couple of real footnotes...
The ENA Emergency nurses must give assistance to families of dying patients so that they can make informed and compassionate choices. Emergency nurses must use clear, appropriate, sensitive, and open-ended questions to draw out the wishes and hopes of the patient and family regarding end-of-life care.

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