The Truth Shall Set You Free…It might piss you off first, but it will set you free.

“Death Panels” the 2009 Lie of the Year is Back!

Posted by politicalmonkey2010 on December 28, 2010

The biggest lie of 2009 courtesy of Sarah Palin is being reincarnated by the right wing nut jobs.   You may recall that Ms. Palin put forth the assertion — that the government would set up boards to determine whether seniors and the disabled were worthy of care — spread through newscasts, talk shows, blogs and town hall meetings.  Then we were all treated to Newt Gingrich, who on  This Week with George Stephanopoulos , said, “You are asking us to trust turning power over to the government, when there are clearly people in America who believe in establishing euthanasia, including selective standards.” (Keep in mind this man may make a run for President in 2012)

So how did the death panel hype become a talking point for the right wing nut jobs?

Effective Jan. 1 – under Medicare which covers yearly physical examinations or wellness visits, the government will pay doctors to advise patients on options for end-of-life care.  The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.    Some how this has all been translated into end of life treatment means ” pull the plug”.  When in fact it can also include a patient giving the directive to say “I want you to use every medical tool at your disposal to save my life.”    But that phrase wouldn’t serve the purposes of the nut jobs would it?  The patient also has the right to say, you know what I don’t want to talk about it.  That is also an option.

The bottom line is that we are all going to die.  It may be from old age, it may be from an accident, it may be from a disease, the end result is the same.  There is a process that occurs, and you can’t deny it.  By allowing a doctor and patient to engage in that dialogue the patient is empowered.   Talking about death in our culture is taboo, we view it as an unnatural process.  It is a discussion that makes us feel ghoulish, but for the person who is facing the end of their life, perhaps it would be comforting for them to know their wishes will be honored.  I come from a state where the Living Will is recognized, BUT the ultimate authority in the absence of a family member giving a directive to stop life support measures means that the medical staff will continue to provide all medical measures available.  Why?  Because they don’t want to be sued.   Situations have forced us to look at death, we have embraced in the past 20 years programs like hospice, which gives the patient the freedom and tools to exit this planet as they see fit.  It is appalling that these right wing nut jobs who profess to be all about freedom want to take away the freedom to discuss and enact your personal choices at the end of your life.

For the record here is the law:

§ 489.100   Definition.

For purposes of this part, advance directive means a written instruction, such as a living will or durable power of attorney for health care, recognized under State law (whether statutory or as recognized by the courts of the State), relating to the provision of health care when the individual is incapacitated.

§ 489.102   Requirements for providers.

(a) Hospitals, critical access hospitals, skilled nursing facilities, nursing facilities, home health agencies, providers of home health care (and for Medicaid purposes, providers of personal care services), hospices, and religious nonmedical health care institutions must maintain written policies and procedures concerning advance directives with respect to all adult individuals receiving medical care, or patient care in the case of a patient in a religious nonmedical health care institution, by or through the provider and are required to:

(1) Provide written information to such individuals concerning—

(i) An individual’s rights under State law (whether statutory or recognized by the courts of the State) to make decisions concerning such medical care, including the right to accept or refuse medical or surgical treatment and the right to formulate, at the individual’s option, advance directives. Providers are permitted to contract with other entities to furnish this information but are still legally responsible for ensuring that the requirements of this section are met. Providers are to update and disseminate amended information as soon as possible, but no later than 90 days from the effective date of the changes to State law; and

(ii) The written policies of the provider or organization respecting the implementation of such rights, including a clear and precise statement of limitation if the provider cannot implement an advance directive on the basis of conscience. At a minimum, a provider’s statement of limitation should:

(A) Clarify any differences between institution-wide conscience objections and those that may be raised by individual physicians;

(B) Identify the state legal authority permitting such objection; and

(C) Describe the range of medical conditions or procedures affected by the conscience objection.

(2) Document in a prominent part of the individual’s current medical record, or patient care record in the case of an individual in a religious nonmedical health care institution, whether or not the individual has executed an advance directive;

(3) Not condition the provision of care or otherwise discriminate against an individual based on whether or not the individual has executed an advance directive;

(4) Ensure compliance with requirements of State law (whether statutory or recognized by the courts of the State) regarding advance directives. The provider must inform individuals that complaints concerning the advance directive requirements may be filed with the State survey and certification agency;

(5) Provide for education of staff concerning its policies and procedures on advance directives; and

(6) Provide for community education regarding issues concerning advance directives that may include material required in paragraph (a)(1) of this section, either directly or in concert with other providers and organizations. Separate community education materials may be developed and used, at the discretion of providers. The same written materials do not have to be provided in all settings, but the material should define what constitutes an advance directive, emphasizing that an advance directive is designed to enhance an incapacitated individual’s control over medical treatment, and describe applicable State law concerning advance directives. A provider must be able to document its community education efforts.

(b) The information specified in paragraph (a) of this section is furnished:

(1) In the case of a hospital, at the time of the individual’s admission as an inpatient.

(2) In the case of a skilled nursing facility at the time of the individual’s admission as a resident.

(3)(i) In the case of a home health agency, in advance of the individual coming under the care of the agency. The HHA may furnish advance directives information to a patient at the time of the first home visit, as long as the information is furnished before care is provided.

(ii) In the case of personal care services, in advance of the individual coming under the care of the personal care services provider. The personal care provider may furnish advance directives information to a patient at the time of the first home visit, as long as the information is furnished before care is provided.

(4) In the case of a hospice program, at the time of initial receipt of hospice care by the individual from the program.

(c) The providers listed in paragraph (a) of this section—

(1) Are not required to provide care that conflicts with an advance directive.

(2) Are not required to implement an advance directive if, as a matter of conscience, the provider cannot implement an advance directive and State law allows any health care provider or any agent of such provider to conscientiously object.

(d) Prepaid or eligible organizations (as specified in sections 1833(a)(1)(A) and 1876(b) of the Act) must meet the requirements specified in §417.436 of this chapter.

(e) If an adult individual is incapacitated at the time of admission or at the start of care and is unable to receive information (due to the incapacitating conditions or a mental disorder) or articulate whether or not he or she has executed an advance directive, then the provider may give advance directive information to the individual’s family or surrogate in the same manner that it issues other materials about policies and procedures to the family of the incapacitated individual or to a surrogate or other concerned persons in accordance with State law. The provider is not relieved of its obligation to provide this information to the individual once he or she is no longer incapacitated or unable to receive such information. Follow-up procedures must be in place to provide the information to the individual directly at the appropriate time.

[57 FR 8203, Mar. 6, 1992, as amended at 59 FR 45403, Sept. 1, 1994; 60 FR 33294, June 27, 1995; 62 FR 46037, Aug. 29, 1997; 64 FR 67052, Nov. 30, 1999; 68 FR 66720, Nov. 28, 2003]



2 Responses to ““Death Panels” the 2009 Lie of the Year is Back!”

  1. gesvol said

    Yeah, it really is hard to imagine how this became known as “death panels” when really it is exactly the opposite of that. A ton of expenses goes to extending lives technically, but not in a meaningful way. To me, it’s just common sense to at least encourage an end-of-life care discussion. But when it comes to some on the extreme right, common sense takes a back seat to fear mongering.

    • The wild thing is that since 2003 this very talk has been done under Medicare for those people with a terminal illness, and we heard no objections about that did we? Now everybody under Medicare has the opportunity to to have this discussion, or not to have it, nobody is forcing anybody to do anything. It seems that once upon a time I felt I was a centrist person, but the more the extreme right pushes the more left I become….some where in the middle is a good place, but the current environment has pushed a monkey to the brink!…Happy New Year by the way 🙂

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