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Death to "death panels"

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I am nauseated that I still need to write about death panels and euthanasia....but apparently, this misinformation is so great that repetition is in order.  I watched Jon Stewart wipe the floor with Betsy McCaughey last night over this issue.  She made so many false claims....she clearly doesn't understand medicine, the legal standards involved with creating advance directives or living wills, or the entire quality improvement movement.  I feel sad for her as she is so misguided.

If you actually want to hear some more thoughtful dialogue on the subject read the NYTimes article by Dr. Pauline Chen. Dr. Chen's article site's an important study from JAMA which draws two crucial conclusions:

1. End-of-life discussions are associated with less aggressive medical care near death and earlier hospice referrals.

2. Aggressive care is associated with worse patient quality of life and worse bereavement adjustment.

So, I ask all Americans out there....who do you want to believe.  Research published in one of the most respected medical journals in the world....or Betsy McCaughey, non-doctor and Chair of the Committee to Reduce Infection Deaths.

Another great NYTimes article to read is At the End, Offering Not a Cure Comfort.  Thoughtful reporting about the difficult issues grappled with at the end of life and the heroic physicians who wade into these complicated and emotional water. Betsy McCaughey and others who seek to disparage these type of conversations disgrace these physicians compassionate efforts.

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  1. doclevittmd


    When I was a kid, we read MAD magazine. One of the bits they did was to make fun of Soviet propaganda. They showed an "OUT TO LUNCH" sign on an office door. The Soviet commentator said that the Americans obviously meant "OUT TO LYNCH". Not only that, but the American educational system was so poor that they couldn't spell "lynch" correctly. This is the intellectual level of the criticisms aimed at the bill by the Wing Nuts. McCaughey didn't even have the sophistication of the nerds who read MAD in the 50s. Another 50s phenomenon the Far Right critics remind me of is McCarthyism. Sooner or later the truth will out, but a lot of people get hurt by the outrageous lies. There are always those who want to believe them


  2. Katherine


    You are absolutely correct, doclevittmd. I actually tried to address the issue on Sarah Palin's Facebook page on four ccasions. After a few posts by Palinites stating that they heard about the "death panels" on Glenn Beck and Limbaugh so I was obviously misinformed(!) they called me a troll and banned me from posting.

    Sean Hannity's blog has a disclaimer that states that anyone posting inflammatory (read anything they don't "believe") will be banned. Same with Free Republic.

    No wonder Rush refers to his listeners as dittoheads!

  3. redshirt4


    This would be comical if it weren't so sad.

    The misrepresentation of Death Panels has reached conspiratorial levels. I have no problems with Doctors getting paid to discuss end of life issues with their patients. It's time in the exam room and if it needs to be discussed then by all means, discuss it. However, that is not the point of contention. As has been the case so often with the discussion of the SGR, distraction rather than meaning ful discussion has superceded significant relaying of information. The right-leaning media and the left-leaning media have taken their eye off the ball on this one. SGR is essentially a tool of rationing invoked by the Congress because their is not enough money coming in to Medicare to pay all the costs associated with the provision of care to seniors. The pie is only so big, therefore, everyone must take a smaller piece to ensure that everyone gets a little bit to keep them wagging and not barking. Unfortunately, because of these ongoing cuts, as the charges for healthcare have far exceeded the available money, I now get 25% of what I was paid to do the same surgey in 1993, even though the outcomes are better and patient satisfaction has sky-rocketed with gains in expensive technology. So far, we have tightened the personel over-head, put off buying new equipment, and ramped up patient flow and absorbed the cuts. Some would argue these were necessary efficiency improvements, however, patients who want to have more than 5 minutes of face time might hagle with that assessment. God forbid someone walk in with something truly complicated, that required imediate attention and much thought and expertise, but I digress. If you follow that it is no great stretch to get to the real issue of 'death panels.' You see in a HR3200 implemented socialistic world, the mir is the most important consideration, or in the words of Spock, "the needs of the many outweigh the needs of the one." You as the doctor will lose autonomy over the decision to include all possible treatment options. A panel, hopefully inclusive of at least a few doctors and not just economists and policy-wonks, will have to decide what treatment options will be available to the masses based on availability of funding for said services. If there is enough money to pay for all needed services then everything is copacetic, if not enough money is available in the system then somethings got to give. Either, we revisit an SGR type fix, we print more deficit money, we raise the contributions of all the enrollees, or they pull the plug on grandma. Let's at least try to have a debate on the real issue and not continue to throw sand in the air by bringing up the end-of-life-discussion camoflage.

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