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Out on vacation
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It’s been a little while since I’ve posted — I’ve been out on two trips with my wife and now 3-month-old daughter, to see some very excited new grandparents. Even out here by the beach in California, though, it’s hard to totally get away from work.
First, about a week or so ago now, a highly inflammatory quote from Sarah Palin made the news rounds, accusing the Obama health insurance reform plan of setting up “death panels” that would deny care to the elderly and the disabled. Turning on the television, the first channel I came across was Fox News, where Glenn Beck was busy drawing not-so-subtle parallels between the bioethical disasters of the twentieth century (including forced sterilization) and current health reform efforts. But perhaps the most offensive, and least escapable, of the anti-reform onslaught was a series of tables outside my grocery store where pleasant, normal-looking, average American citizens were casually chatting up passersby in front of a giant picture of President Obama with a Hitler mustache and other Nazi references. Onlookers seemed actually interested in this stuff and sympathetic to the cause.
What in the world is all of this about? Apparently, most of this recent round of angst is targeted at a provision within one of the bills that would reimburse health care providers for end-of-life counseling. To me, this provision doesn’t seem all that controversial. This is something that we as physicians have been trained and encouraged to do throughout medical school, residency, fellowship and beyond. All too often, we see the consequences of failure to have these discussions — care delivery that is inconsistent with patient preferences, prolonged pain and suffering, devastating emotional toll on families, and death without dignity.
“End-of-life counseling” is about discussing goals and preferences and has absolutely nothing to do with euthanasia or rationing care. ASCO president Douglas Blayney discusses these issues in a CNN commentary. Despite the baselessness of the claims by Palin and others, though, their nonsensical arguments seem to be gaining traction and not losing steam. Ignorance and intolerance remain alive and well.