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In the article, ‘Death Book for Veterans’, written by Jim Towey for the Wall Street Journal on August 18, Mr. Towey briefly explains the ‘Your Life, Your Choices’ document that is given to veterans regarding their ‘end of life care.’ From the article:
“Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."
This ‘end-of-life’ planning document is now being distributed to all Veterans receiving care:
“…a July 2009 VA directive instructs its primary care physicians to raise advance care planning with all VA patients and to refer them to "Your Life, Your Choices." Not just those of advanced age and debilitated condition—all patients. America's 24 million veterans deserve better.”
I downloaded a copy of the ‘Your Life, Your Choices’ document and for the most part it seems like a typical document discussing Healthcare proxies etc. The things that are discussed with elderly parents or even husbands and wives in planning their futures; however, there is a check list in the middle of the document that specifically asks questions about "What makes your life worth living?”. It is a checklist that doesn’t just include needing a feeding tube or being on permanent life support, the questions are absolutely, in my opinion, insane. These questions are being asked to all Veterans receiving treatment, including 20 year olds who have been severely wounded in Iraq or Afghanistan. I have listed all of the questions below so you can see for yourself:
a. I can no longer walk but get around in a wheelchair.
b. I can no longer get outside—I spend all day at home.
c. I can no longer contribute to my family's well being.
d. I am in severe pain most of the time.
e. I have severe discomfort most of the time (such as nausea, diarrhea, or shortness of breath).
f. I rely on a feeding tube to keep me alive.
g. I rely on a kidney dialysis machine to keep me alive.
h. I rely on a breathing machine to keep me alive.
i. I need someone to help take care of me all of time.
j. I can no longer control my bladder.
k. I can no longer control my bowels.
l. I live in a nursing home.
m. I can no longer think clearly-I am confused all the time.
n. I can no longer recognize family/friends
o. I can no longer talk and be understood by others.
p. My situation causes severe emotional burden for my family (such as feeling worried or stressed all the time).
q. I am a severe financial burden on my family.
r. I cannot seem to “shake the blues.”
These questions are followed by the questions below:
“If you checked "worth living, but just barely" for more than one factor, would a combination of these factors make your life "not worth living?" If so, which factors?
If you checked "not worth living," does this mean that you would rather die than be kept alive?
If you checked "can't answer now," what information or people do you need to help you decide?”
What the hell kind of questions are these to be asking Veterans who have just risked their lives to keep America safe from terrorists? What kind of person would ask a 20 year old quadriplegic if they would rather die than be in a wheelchair or a burden to his/her family or if they have the blues? Of course they would have the blues in this case and of course no one wants to be in a wheelchair and of course no one wants to be a burden on their family but to suggest to a Veteran that these answers possibly mean they would ‘rather die than be kept alive’ is atrocious, outrageous, disgusting, immoral, unethical and one of the most un-American things I have ever read in my entire life.
To even suggest the above questions to ANY Veteran is outrageous or to any person for that matter. I understand the ‘Do not resuscitate’ questions and the ‘brain dead’ type questions but as you can see above the majority of the questions are not pointing to those scenarios. People live completely full lives in wheelchairs and nursing homes. Some people choose to never go outside. Many people are alive today because of kidney dialysis and they too live full lives. And my God, question ‘p’ incites me the most. I watched my own Mother die of cancer, I was emotionally stressed and worried but it was by no means a burden. To suggest that the care of someone you love is a burden is atrocious.
Our Veterans deserve better than Obama’s directive to hand out this questionnaire. Our men and women of the armed forces sign up to protect and serve America knowing the potential risks that are involved. They do not hesitate to risk their lives for our freedoms. Their care should never be considered a burden by any member of our society. For anyone to ever suggest to someone who just risked his or her life that they may want to die rather than be in a wheelchair or nursing home is abominable. Our Veterans deserve better than this and this directive should be stopped immediately. If Obama is willing to treat our Veterans this way, how do you think he will treat the rest of America?
Comments
And this skunk wants to run everyone's health care. Over our dead bodies. Oooops. I shouldn't give Barry any ideas.
Liberals are beside themselves with rage. They are recounting how their parents lost their jobs during the McCarthy period, and telling each other that opposition to the president's program is all about racism.
You can tell the Democrats are in trouble when a naïve hockey mom from Alaska can appear out of nowhere and wrestle the entire Democratic Party to the ground. After all, when it comes to "death panels" for grandma you have the American people on one side and you have "comparative effectiveness research" professionals and rational ethicists on the other. How come Sarah Palin could see that and the intelligent President Obama could not?
Even though this book starts out with a "death for dummies" approach, when one actually reads it, the book is not cute, nor funny, and definitely NOT written to consider life rather than death. It is ghoulish... The administrators and writers of this book should be ashamed. I suspect they would never give such a thing to a member of their family...
I'm not quite sure that you're representing the purpose of the questionnaire you're citing.
It almost sounds like you're reading and describing something that should be called an "If you can answer yes to any of these question, you should take your own life" questionnaire.
That's not what the list is about. Putting it back into context is very important.
You've not mentioned that the list of questions is one of four "Thought-Provoking Exercises" as shown two pages before this questionnaire.
You've omitted the fact that the questions also have multiple suggested replies, from "Life like this would be difficult, but acceptable" to "Life like this would be *not* worth living."
The purpose of "Your Life, Your Choices" is to help veterans make considered, informed decisions about living wills/advance directives. To do so, a well-written guide should ask hard, provocative questions.
This guide does just that. Calling it a "death book" is a terrible misrepresentation.
Victor I would agree with you except that those questions are absolutely not life or death or DNR questions. Can't you see that??
If you can't 'shake the blues' would you rather die??? Come on.
These questions are completely inappropriate. What happens if someone says they'd rather die than be in a wheelchair?? Then what??? The Gov't is making it sound like any of those questions would not allow the person to live a full life OR be productive. I wouldn't ask ANYONE the majority of those questions. They aren't TOUGH questions they are 'leading' questions and not the type of questions you present to anyone who happens to be back from the war with injuries. It is atrocious and I'm not reading too much into it.
Oh and Victor I didn't call them Death Books, I was quoting from Jim Towey's article.
Im pretty sure veterans, just home from war, are the last people we need to protect from talking about death. By your reasoning it is sheer insanity to suggest these boys have wills before they go into battle as well (how dare we suggest a to person willing to fight for our country that they may die?? dont you get that!)
They were given the responsibility of fighting for our country, it is an insult to think they cannot be responsible for themselves. You are saying that they just want to kill our veterans, that they must be kept alive no matter what. I disagree on both fronts. I think they want our veterans to choose their own terms of life, that they are saying to those men "listen you fought for us, now you get to choose how you want to live, you earned it". If a soldier says "keep me alive at all costs" we better damn well respect it. If he says "not like that" then respect that too. Of course you just want to complain about liberals, not actually care about our veterans.
I talked with a vet yesterday whom I had seen at Golden Corral on Monday, and had noticed the huge tumor on the right side of her neck. While at Bojangles yesterday, I saw her again. In talking with her, she told me she'd been waiting for surgery to remove it for 11 years. No one, especially a Veteran should ever have to wait years for treatment. This is wrong, and where everyone of us are headed
Heard today that Obama didn't know where to go with everyone against his healthcare program. I can tell him where to go, "BACK TO KENYA, AND COME BACK THE RIGHT WAY IF YOU WANT TO STAY IN THE USA." This man is not a naturalized citizen and has no business here, and certainly not in the Whitehouse, trying to control everything. GO BACK TO YOUR HOME LAND AND LEAVE US ALONE.
Kimberly, I don't think you're reading too much into this at all. ESPECIALLY when you couple this with the spate of movies in the past few years which have been persistently raising the topic of "dying with dignity", or "accepting that it is your time to die". I wouldn't think much of it, if we hadn't had testimony from movie and TV writers in the past that government bureaucrats on occasion "encourage" them to introduce certain themes into their work.
It could just as easily be navel-gazing by a bunch of Hollywood type who've led long, shallow, meaningless lives, but I've seen that meme an awful lot in the past few years, even in movies for KIDS of all places.
Notice how often that idea is cropping up in all sorts of places. It featured prominently in the health care debate. Could just be an example of a bad idea reverberating in the echo chamber that passes for statist's minds, but could also be a concerted campaign.
When that lady in Florida was a vegetable and the Republicans threw together emergency legislature to help keep her alive, wasn't it "Living Wills" that they were pushing so that situation wouldn't have to be repeated?
What, exactly, has changed between then and now?
And also, you do realize that a living will is not used unless the person has gotten so sick that they're unresponsive and no known means of medical intervention is likely to bring them out of it? My wife works for lawyers who put these together all the time. In the living will, you can say "keep me alive, try everything, don't let me die under any circumstances no matter how many machines I'm hooked up to." ....which would make this a "Keep me alive Book" and not a "Death Book". You can also go in the other direction. But it's YOUR choice, not someone else's, not the government's.
I think everyone is using talking points and political arguments instead of common sense.
Sean did you actually read the questions?? LIVING in a wheelchair is not on your death bed. Unable to 'shake the blues' is not on your death bed... Do you see the problem with this?? I agree with Healthcare proxies/living wills etc. But this goes much further than that and for what reason exactly??
Ppl get kidney dialysis every day, ppl LIVE in nursing homes every day...
The questions are suspect BECAUSE many have nothing at all to do with end-of-life AND they give them to EVERYONE.
I am so sick and tired of veterans being the sacred cows of society. They get tons of taxpayer funded freebies. No one is drafted anymore; they choose to enlist and they know the risks. War does not prove who is morally superior; it just proves who has superior firepower.
Are you serious George? Soldiers DIED in order for you to be able to say that absolute CRAP!
I wonder how long you'd last in bootcamp... nevermind war!
Holy-frickin-crap. It's just a questionaire designed for people to think about how they give their lives value. I was in the military and, especially enlisted people, are treated like children in every aspect of their duty. This seems like a perfectly normal type of "questionaire" they would be forced to fill out. It's not titled, "5 or more 'Yes' answers and maybe you should think about ending it all." Christ.
Will these fear-mongering conservatives please speak, or write, with an ounce of reason and logic.
Sean Hannity should pick up this article for his next "Socialized Healthcare will Kill Us All!" episode.
Kimberly, I have read this document, and the questionnaires you mention as being "atrocious, outrageous, disgusting, immoral, unethical and one of the most un-American things I have ever read in my entire life" and I think it's clear where your political agenda lies. This document should be given to military personnel as they enter the service. You, and others on the "right", mis-represent this document as another way to scare people away from government "funded" healthcare, which is how it should really be referred to, not government "run" healthcare.
The article states “Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document". President Bush was the POTUS last year. So even though it appears that the document was stopped under the Bush administration, it appears that it also was re-instituted under the Bush administration, as Obama did not become President until Jan 2009.
Kimberly,
I do not know why you waste your time trying to reason with these Obamabot zombies. These people would follow Dear Leader, Chairman Mao-bama and the other Marxists in the Red House right over a cliff chanting "yes we can" as the plummet to their deaths.
Az Vet and Scott - first THANK YOU for your service...
Second - tell me something... if you decide you don't want to be in a wheelchair what exactly is the VA going to do for you? If you decide that you 'can't shake the blues' what are they going to do? I didn't even get INTO the topic of WHY they are asking these questions but these are NOT 'end-of-life' healthcare proxy type questions.
Are the two of you that blinded that you don't see how wrong these questions are?? If I told my husband I'd rather die than be in a wheelchair, what should he do??? Kill me?? This is extreme but do you understand why I think these questions are ridiculously outrageous???
AZ Vet, blaming Bush does not change the date of July 2009.
Obama's regret as a Senator was not speaking up against his fellow Senators who intervene on the behalf of Terri Schiavo.
Rather it's the beginning of life (abortion) or the end as in Schiavo's case Obama & the elitist left have no problem in chosing death for others.
I had some work completed on my heart about a year ago. then a few months ago I get this mini book that they are talking about I remember it was about a living will and soforth. I can remember that I read through it and thougt hwat kind of morbid person at the VA would send me somthing like this? I broke down and started crying. I mean you just went through a heart attack and all the problems that go with it and now someone is wanting to see if you need help deciding if your life is worth keeping? I threw it away, but now I wish I would have keep it. A lot of things are making sence now.
OK, Kimberly; I'll concede that soldiers died so I can say this "absolute crap" --- in World War II. They are dying in Iraq because your hero George W. decided to pick on a little guy who had nothing to do with 9/11, never was proven to be and never WAS a threat to us and who not mention was put into power by the US until he was no longer of use to us.
Americans have never voted for Eurosocialism. Obama didn't get elected to turn the country upside-down. People like Daniel Hannan, who know the dubious joys of Eurosocialism in Britain, are telling us this is a disastrous idea. Britain is going down the tubes because the welfare sector is siphoning off all the tax money. Nobody can vote the Ruling Class out of power any more. The British Armed Forces are in dreadful shape because their money is gone.
American medicine ain't broke. All the sqeegee guys swarming around our health care look like they're in it for themselves, and not to actually fix things. Some Europeans think that we are crazy even to think about going down this road.
Would you buy a used car from this crowd? Or turn your medical care upside-down? I wouldn't.
It ain't broke.
Don't you touch it.
Kimberly,
While I would agree with you that "shaking the blues" may not constitute a DNR condition, I think you would agree that "I rely on a feeding tube to keep me alive" may constitute a DNR condition... or, at least, merits thought about whether it does or not.
That's the purpose of the exercise. To think about things that might not come to mind everyday, and to discuss them with loved ones and health care providers, just as the instructions note.
Are the questions inappropriate? Certainly not. They're provocative, challenging and deliberate. Questions like these are part of the normal living will/advance directive counseling process that everyone should participate in, not just veterans.
You asked "What happens if someone says they'd rather die than be in a wheelchair?" I would answer that that person had better have a conversation with their family and their doctor. An answer like that might signify a need for counseling.
Desegregation started in the military leading to civil rights. Drug Testing started with the military leading to pre-employment and random screening. Are you noticing a trend yet?
Shout out to fellow vets (I am proud of and honor by the opportunity to have served my country, subs 1977-1985). Quick question, while you were serving, when did you realize you did not have the civil rights you were defending? I was a volunteer but comforted myself with the thought I was defending the rights of my fellow Americans. Having read in HR 3200 about uploading my medical and financial records to the federal government wondering what are your thoughts?
WOW! Somehow, I missed this & wil pass it around! THANKS!
Boo57 - if nobody else noticed that a real, honest to god vet checked in and told us that this damn little booklet had exactly the effect Kimberly was worried about, I sure as hell did. Thanks for your service, soldier, and sorry those stinking bureaucrats put you through that.
This is not an Obama creation. This booklet has been around far before Barack came about. Guess when it was stopped? When Bush took office. Why is everyone so afraid of acknowledging the fact that we are all going to die? Wouldn't you rather have a plan to assist your families during your time of death? Would you want to live if you were a soldier in Iraq who lost multiple limbs to a roadside bomb, and the ability to move or communicate freely has been lost as your brain sits barely functioning in your shrapnel riddled skull? Would you want to live as a wheelchair bound vegetable barely living and hoping day by day that the food and nutrients pumped through your body by iv keep you alive for maybe another day? Do you know how much it costs to keep a person on life support like that? What if the person's family can't afford to keep their loved one on life support because they have no health care? People need to realize that there's a point when a human life should naturally end.
Also, why has socialism become a bad thing? Maybe a country in a serious point of decay needs a serious plan for revival. Even if that is an idea that a generation raised through the Cold War was taught to believe as being wrong and evil.
If it'll help, why is it bad? Because it's different from what you're comfortable with?
How about a small reality check? I work in VA geriatric health care research. We care deeply about US veterans' well-being and, unlike the author, spend our working lives finding out what veterans need for their physical and mental well-being. I wish it wasn't necessary to write that so explicitly. These "outrageous, immoral" questions were developed to help veterans and their families consider what gives their lives value, as a result of many, many interviews done by VA researchers with veterans who were in end-of-life care. That is, it was veteran respondents themselves who identified the conditions listed in the questions as affecting quality of life, alone or in combination.
if it is legal to kill a healthy unborn baby i see no reason why the government cant suggest an unhealthy unproductive member of society find somewhere to die. i hope those of you that find this article atrocious will realize how atrocious abortion is by comparison.
How about a small reality check? I work in VA geriatric health care research. We care deeply about US veterans' well-being and, unlike the author, spend our working lives finding out what veterans need for their physical and mental well-being. I wish it wasn't necessary to write that so explicitly. These "outrageous, immoral" questions were developed to help veterans and their families consider what gives their lives value, as a result of many, many interviews done by VA researchers with veterans who were in end-of-life care. That is, it was veteran respondents themselves who identified the conditions listed in the questions as affecting quality of life, alone or in combination.
I guess the next thing for vets will be an exicution of us all at the end of any war. That will save money for transporting us home and any future VA benifits.
two things. 1. Last I checked, euthanasia is not legal. Therefore, if you answer, life is not worth living, I don't think you're taken out back and shot. They might not life or death questions, but they are intended to help people think about the overall situation they might be in when they reach a life or death situation.
2. If you are a rational human being, focus on rational arguments. Calling Obama "Barry," Chairman Mao-bama, generalizing liberals (OR conservatives), calling something a "Death" book or "Death" panel instead of actually explaining or researching what it is... there is nothing rational about this. Please, let us have a rational argument. Bush didn't deserve Hitler comparisons, Obama doesn't deserve Hitler comparisons, and if you have a legitimate point, let's discuss the point instead of being offensive or ignorant.
I just did a quick search to check my memory on this, and found that the only mention of Hitler at all was your post. You're also factually wrong on at least a couple of points - Oregon at least DOES have a legalized form of euthanasia:
www.oregon.gov/DHS/ph/pas/index.shtml
Please note, sir, that I am pointing you at the Oregon state website, not some... how did one of you put it? Oh yes, "fear mongering conservative" website. Guess this would be one of them "inconvenient truths", huh?
Secondly... very minor point, but worth driving home just to cut down on the snarkiness level here. Multiple sites around the web report that "Throughout his early years, Obama was known at home and at school as "Barry."" Here's a link to one of those "fear mongering conservative" sites:
www.chicagotribune.com/news/politics/obama/chi-070325obama-youth-story-archive,0,3864722.story
Oops, my bad, it's a respected newspaper.
I guess the next thing for vets will be an exicution of us all at the end of any war. That will save money for transporting us home and any future VA benifits.
(grin) 173dave, while I understand the gallows humor in that comment, it does rather play into the horrified "progressive's" (or *whatever* the marxists insist on calling themselves today) claims that those agreeing with Kimberly's premise here are engaging in hyperbole. Now, me, being a bush-league polemicist myself, don't see a big problem with hyperbole. It really seems to get the Obama supporter's panties in a twist, though, unless they're the ones using it. So I think I'm gonna insist on a standard in any thread I'm involved in...
You can't make any snide comment about Obama that is materially worse than anything said about Bush, Sarah Palin, tea party protestors, town hall participants, or Ron Paul. It just really does not seem that much to ask that one maintain the standards of civic discourse established so firmly by the statist left.
In Oregon, euthanasia is only for the terminally ill. The point remains, if you felt life in a wheelchair was not worth living, that wouldn't be grounds for any system to end your life. Not really an "inconvenient truth", or very relevant to this article, but you are right, it's my mistake.
Also my statement about Hitler was meant to be a more general comment about the discourse going on all across America, not specifically this forum. Kind of the same way you used "inconvenient truth" or "fear mongering conservative," - though I do believe that renaming things "Death" this and "Death" that is a form of fear mongering. However, I wouldn't isolate it as a conservative tactic, and I think people have real issues with this book and I would rather the focus be on those issues than these catch phrases.
The Bary thing is also another technicality. Nickname or not, it was being used here to denote a tone of disrespect(?), and I again find that distracting in regards to the issues.
"You can't make any snide comment about Obama that is materially worse than anything said about Bush, Sarah Palin, tea party protestors, town hall participants, or Ron Paul. It just really does not seem that much to ask that one maintain the standards of civic discourse established so firmly by the statist left."
I hope you realize that plenty of people on the left were just as frustrated by the left engaging in that kind of discourse. I think all that hyperbole and propaganda undercuts any real issue in an argument, and so I have always been against it, and I'm sure I'm not alone in that. In fact, my biggest problem with politics in general is that we have resorted to that as our primary way of debate, and that goes for dems too...
For God's sake Kimberly, have you ever actually spent time with the elderly? Those of us who work in healthcare and have watched families and patients agonize about end of life care know the value of a book like this. Have you ever seen someone afraid that their wishes would not be honored if they were unable to speak for themselves whether they wanted everything done or nothing done? Or how about watching siblings tear each other apart while they decide if mom really wanted this or that? It's godawful. I have also met people like you who assumed they were going to die at home peacefully in their sleep while their children and grandchildren sang them into the next life. Guess what? That almost never happens! This information is empowering and everyone should have it. And it is only information after all, no one is forcing anyone anywhere to sign it. Knock it off!
I am going to reiterate what I have already said in my article - I DO NOT have a problem with this document other than the specific questions I refer to in the article. I completely AGREE with Healthcare proxies etc.. I even have my own for God's sakes. So please stop inferring that I have issues with this or I don't like the elderly etc.. I have had to deal with this issue personally with BOTH of my parents. I have SPECIFIC issues with SPECIFIC questions as I stated IN the article.
Like putting down dogs....for all you in favor of putting the elderly down, start with your own parents, sisters, brothers, then INCLUDE the government workers (who, by the way, are not going to be subjected) to mass murders.
As for Sharon.... You are a disgrace to nursing and should quit. If it bothers you, wait a few years until YOU are lying in that bed awaiting the "nurse with the needle" ...
A - I know that very well, I have plenty of lefty friends, though they tend to be a lot more reasonable than a lot of the real crazies we're talking about here.
Now, so far as "Barry" being disrespectful, you're darn right. When he earns some respect, I'll give it to him. Come to think of it, I did grant him kudos in my next article. I don't like the fellow for what he stands for. He's demonstrably a liar, and he's advocating a murderous political philosophy that I've fought against my whole life. He's hardly unique in that regard, I'd cheerfully put every president who's served in my lifetime up on trial for crimes against the Constitution and hang them myself if we could secure the convictions they all so richly deserve.
But we live in an imperfect world, so I have to settle for giving their followers heartburn. And every once in a while getting one or two of them to realize how badly we've all been had. (shrug)
Only the vaccuous brained believe this death book claptrap. After Terry Schiavo a record number of people made living wills. Perhaps the perpetrtors of these lies are fearing death a bit more knowing there is a special hot place reserved for them.
How is asking a veteran or any patient for that matter how they are feeling about the situation they are facing, bad for the patient? I thought that was sound medical practice to ask about possible suicidality, depression, and barriers to health care. Thank you to the origional writter for posting your profound inadequate knowledge of the VA health care system.
How is asking a veteran or any patient for that matter how they are feeling about the situation they are facing, bad for the patient? I thought that was sound medical practice to ask about possible suicidality, depression, and barriers to health care. Thank you to the origional writter for posting your profound inadequate knowledge of the VA health care system.
This breaks my heart. Our vets deserve better .
again people are dupped, this book, is no different then all the questions asked in hospitals everyday, this info was started under the bush administration not the present, I am a disabled vet who happens to work in the health care industry, take your scare tactics and go somewhere else
This booklet was written in the Late 1990's... NOT by the Obama Administration.
The Obama Admin. has recognized that the booklet needs to be Reviewed and Rewritten.
The Obama plan will get doctors to talk with patients about End-of-Life care, that's all.
This is something that really should be done - but MD's have been AVOIDING.
Thank God for FOX News and great local papers like yours. The MSM has been trying to sweep this under the rug to cover Nobama's liberal little tail.
My grandson sent me a great email with a website that expanded on the original Death Book Op ED, and supported it with evidence from the original pamphlet and Veteran's Administration directives. Give it a read -- obamasdeathbook.blogspot.com/
We need to spread the word about this and stand up against it, our brave men and women deserve so much better.
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