By Peter J. Smith

See Part I: Bowling for Death Panels: Euthanasia Group Behind “End-of-Life” Counseling

WASHINGTON, D.C., August 20, 2009 ( – Americans worried about President Barack Obama's health care reforms turning into “death panels” have a new cause for concern: the Obama Administration has mandated that government-run Veterans Affairs hospitals give their patients a handbook on advanced directives including “end-of-life counseling” created by advocates for legal euthanasia.

Last week, reported that Compassion & Choices, formerly known as the Hemlock Society, is aggressively promoting a measure (sec. 1233) in the “American Affordable Choices Act of 2009” (HR 3200) as the “centerpiece” of health care reform. (see coverage here) The proposal is to incentivize doctors and medical professionals to offer “end-of-life” consultations every five years with elderly and infirm patients, and offer them more frequently as a patient's health condition deteriorates ever closer toward death.

However, opponents fear this could lead to medical professionals initiating conversations that could pressure patients into accepting lower-quality care or into denying themselves life-sustaining treatment, such as antibiotics, or “artificially administered nutrition and hydration.”

Since government would control the rate of medical reimbursement, it could substantially increase the financial incentive for doctors to have these conversations, especially in a possible scenario of dealing with runaway health-care costs. Just last Friday, the Obama Administration revealed government deficit would increase $9 trillion over the next ten years, nearly doubling a national debt already totaling $11.67 trillion.

“There are legitimate concerns that it would give doctors a financial incentive to encourage patients to sign pull-the-plug orders, and that patients would feel pressured to do so by the doctor's authority,” said Jim Towey, a former director of the White House Office of Faith-Based Initiatives (2002-2006) and founder of the nonprofit Aging with Dignity, in an article written last Tuesday for the Wall Street Journal.

Towey writes that concerned Americans should look no further than the government's Department of Veterans Affairs (VA), which has an advanced directives manual called “Your Life, Your Choices,” authored by Dr. Robert Pearlman, the chief of ethics evaluation at the VA's National Center for Ethics in Health Care. Towey points out that Pearlman advocated for physician-assisted suicide in 1996 in the US Supreme Court case Vacco v. Quill and also is an advocate for health-care rationing.

According to his VA bio, Pearlman's chief expertise is “clinical ethics (especially end-of-life care)” and has focused his research on “euthanasia, medical futility, advance care planning, physician-assisted suicide, and relief of patient suffering.”

The 52-page end-of-life planning document, as Towey explained, “presents end-of-life choices in a way aimed at steering users toward predetermined conclusions,” and also “lists various scenarios and asks users to then decide whether their own life would be 'not worth living.'”

Such scenarios have VA patients consider whether: “I can no longer contribute to my family's well being,” “I am a severe financial burden on my family,” and that the patient's health condition “causes severe emotional burden for my family.”

But Towey points out that “the only resource” on advance directives cited in “Your Life, Your Choices” is the pro-euthanasia organization Compassion & Choices, while faith-based or disability-rights advocates are not included as a resource. found that the 1997 version included contact info only for Choices in Dying, a predecessor to Compassion and Choices. However, the official VA link to the version updated this year by the Obama Administration is now disabled. LSN found that the site now only features the first edition, but with the last page on “other resources” conveniently missing.  

“When the government can steer vulnerable individuals to conclude for themselves that life is not worth living, who needs a death panel?” asked Towey, pointing out that the Obama Administration resuscitated the manual after the Bush Administration had banned the VA from giving it to the nation's wounded and disabled veterans.

Towey added that the VA instructed its doctors last month to discuss “advanced care planning” with all VA patients and “to refer them to 'Your Life, Your Choices.'”

Dan Kennedy, CEO of Human Life Washington, told that much of the problem with the massive health-care overhaul of HR 3200 is that the language leaves too much room open for interpretation, and that can have enormous consequences down the road as government bureaus or courts fill in the details.

“People need to realize, that any health care legislation that is passed, though appearing to be compassionate, will not be very detailed,” warned Kennedy. “Unfortunately, the details will be filled in by government bureaucrats in close consultation with Compassion & Choices – the former Hemlock Society. It is true, the devil is in the details.”

“Hopefully, the American people have grown weary of buying on faith what the government has been selling.”

The latest polls reveal that just may be the case. According to a recent Rasmussen poll, 54 percent now say that no health care reform this year would be preferable to the current legislation working its way through Congress.

Related items of interest:

The Death Book for Veterans
“Your Life, Your Choices” (1997 Version)

Heritage Foundation: This Is What Government Rationed Health Care Looks Like

Read related coverage by

Bowling for Death Panels: Euthanasia Group Behind “End-of-Life” Counseling


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