Extreme language for drastic measures

The term “death panels” is fairly over the top. So is the reality of futility care practices sort of de facto form such squads.

In Texas, a legislative provision that many thought was
an innocuous proposal to help people has been twisted to snatch
end-of-life decisions out of the hands of families.

It’s the one Sarah Palin has referred to, riling up heated debates:

The provision to which Mrs. Palin refers, Section 1233
of America’s Affordable Health Choices Act of 2009, would allow
Medicare to pay doctors to counsel or steer end-of-life decisions for a
patient every five years or more often “if there is a significant
change in the health condition of the individual” or an admission to a
nursing home or long-term care facility. Both the White House and some
members of Congress dispute Mrs. Palin’s contention about how this
language would play out, but based on what has happened in Texas,
Americans should heed her warning.

The next line is key:

One of the drawbacks of trying to overhaul an industry
as large and sweeping as health care on the short schedule demanded by
the president is that there is not time to study how the legislation
would work in the context of existing state law.

Take Texas for example…

The Texas Advance Directives Act of 1999 became law with
support from a broad ideological spectrum, but one of its unintended
consequences has been astounding. When a patient or family wants health
care to continue but the attending physician does not, the Texas law
allows a hospital committee to have the final say under the amorphous
concept of “medical futility.”

Texas law only requires the hospital to provide the patient and
family with 48 hours’ notice before a hospital “ethics” committee meets
and makes a decision on terminating life support. There are few
due-process safeguards in the law to protect patients during this
committee proceeding.

Once the hospital ethics committee decides that further care is
medically futile, the family is given just 10 days to find a facility
that will accept the patient, or the hospital and doctors can end
curative care with impunity. Virginia law is similar but gives the
family 14 days.

These are clear and definitive examples of what lies ahead if
significant changes aren’t made to the health care proposals in

Sen. Charles E. Grassley, Iowa Republican, is rightly
concerned that the end-of-life provisions in the proposed federal law
could be “misinterpreted and implemented incorrectly.” Federal
lawmakers interested in protecting individual and patient rights need
to study carefully the end-of-life provisions with the understanding
that the law will be implemented in health care settings governed under
50 different sets of state law…

If the Texas Advance Directives Act has shown us anything, it is
that governments should leave end-of-life decisions to patients and
their families.


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