Friday, August 14, 2009

Sarah Palin Sponsored "Euthanasia Day" as Alaska Governor

Sarah Palin sponsored "Euthanasia Day" as Alaska governor. Well, actually, it was called "Healthcare Decisions Day." The day was specially recognized to encourage Alaska residents to get information about end-of-life issues. Yes, hypocrisy prevails -- with even greater force than I initially believed. Think Progress has the messy details, but I visited the Alaska government website to get the full breadth of Palin's rancid hypocrisy:

WHEREAS, Healthcare Decisions Day is designed to raise public awareness of the need to plan ahead for healthcare decisions, related to end of life care and medical decision-making whenever patients are unable to speak for themselves and to encourage the specific use of advance directives to communicate these important healthcare decisions. [...]

WHEREAS, one of the principal goals of Healthcare Decisions Day is to encourage hospitals, nursing homes, assisted living facilities, continuing care retirement communities, and hospices to participate in a statewide effort to provide clear and consistent information to the public about advance directives, as well as to encourage medical professionals and lawyers to volunteer their time and efforts to improve public knowledge and increase the number of Alaska’s citizens with advance directives.

WHEREAS, the Foundation for End of Life Care in Juneau, Alaska, and other organizations throughout the United States have endorsed this event and are committed to educating the public about the importance of discussing healthcare choices and executing advance directives.

WHEREAS, as a result of April 16, 2008, being recognized as Healthcare Decisions Day in Alaska, more citizens will have conversations about their healthcare decisions; more citizens will execute advance directives to make their wishes known; and fewer families and healthcare providers will have to struggle with making difficult healthcare decisions in the absence of guidance from the patient.

So, it was fine for the State of Alaska to encourage its residents and medical professionals to talk about end-of-life issues and to prepare medical directives and living wills. But, as an annoying rabble-rouser seeking to prevent honest debate about healthcare reform, this same policy amounts to a "death panel." Good one, Sarah. Real cute.

On the utter hypocrisy of Palin and Grassley regarding this issue, see: Dumb and Dumber on Death and Dying.


Stray Yellar Dawg? said...

Again, I think the essential question is ... did the Alaska initiative encourage the same people who do health cost containment to do end of life counseling?

I hate to be a stickler for this kind of detail... but it's a critical point in health care ethics.

Linking end of life counseling to a health care payment scheme of any sort is the problem.


Darren Lenard Hutchinson said...

Hi. Thanks for raising issues.

1. This was not attached to any payment or provision of care.

2. Hospitals were encouraged to participate. Certainly they have "bottom line" issues, but they didn't receive compensation.

3. I can see this as a "potential" problem, but how do you incentivize medical professionals to do something that is underutilized and that takes time (i.e., is costly)? I think all people would agree that this type of counseling is sound from a medical perspective. The question then becomes how do you encourage it.

It seems to me that the a much more specific ethical issue would involve a doctor declining to treat someone simply to save money. That can happen (and probably does happen) even without this provision. I am sure that some doctors and family members encourage patients to refuse life-sustaining medical treatment in order to save money.

If this type of counseling became available earlier and with greater frequency, wouldn't we have a greater sense of the patient's true intent? If so, then doctors could not encourage a decision later, when the patient is incapacitated, simply to save money.

Darren Lenard Hutchinson said...

Ooops, I forgot No. 4: Palin described simply talking about these issues as appearing before a death panel. Whether or not the medical provider is compensated or is responsible for controlling costs, that notion is reprehensible.

(5) Also, I just rememberd that the statute does not specifically authorize people who do cost containment to do the counseling. Instead, doctors and nurses are authorized to do so. And while doctors will certainly want to contain costs, aren't they and/or nurses already responsible for these conversations in the first place? Other than delegating the responsibility to nurses or a newly created staff, then you will always end up with someone having a financial stake.

Because this is part of medical advice, I cannot imagine a doctor NOT having a role. Accordingly, how would you avoid the "ethical" issue?

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