Just Hurry Up and Die, Will Ya?

[Don Corleone]

From the US Veteran's Affairs Bureau, a booklet titled "Your life, your choices". The booklet is a publication which encourages disabled veterans to consider whether their life is really worth living, or wouldn't they and society be better off if they just refused care and just let themselves die. In its defense, they don't actually answer the question themselves, it's more of a push-poll.

The booklet was originally published in 1997, under the Clinton administration. It was suspended during the Bush administration, and was just restored to the VA website a couple of weeks ago.

I can think of two headlines:

"Democrats baffled at lack of ability to attract senior veteran vote..."

"Here's how we intened to control costs...."

[HoreTore]

Uhm................

Am I reading a different link than you? Because, you know... what I'm reading looks an awful lot like instructions on making a living will... And those are quite handy, you know, and I'd say it's even more handy for a soldier to have...

[Tribesman]

Its a good move, where there is a legal standing concerning "living wills" people should be encouraged to make them.
So Don to you have a problem with people deciding they don't want to be kept as not quite dead yet, hooked up on a life support machine indefinately?

[Don Corleone]

Read Page 12, where they discuss Mrs Chen, and heavily but indirectly editorialize that people with dementia should not be given feeding tubes.

I'm not opposed to living wills, I'm all for them. I'm upset with the tone of the pamphlet... "Rational people who care about society would choose to end treatment here, but you have to make your own choice" seems to be the gist of it.

[HoreTore]

Read Page 12, where they discuss Mrs Chen, and heavily but indirectly editorialize that people with dementia should not be given feeding tubes.

Uh...

That's reading a little too much into it, isn't it? The issue is sound; do you yourself want those tubes, or do you want to die instead? It's the basic question one has to consider when making a living will, and that's what this booklet is about, isn't it?

As for myself, I know I would like to die in that situation. Actually, much earlier than that. Same goes for my mother.

I'm not opposed to living wills, I'm all for them. I'm upset with the tone of the pamphlet... "Rational people who care about society would choose to end treatment here, but you have to make your own choice" seems to be the gist of it.

I certainly didn't get that impression from the pamphlet. So I guess we'll just have to agree to disagree...

Btw, as this pamphlet was suspended during Bush, what pamphlet did he provide instead of this one to help people create a living will?

[Tribesman]

Read Page 12, where they discuss Mrs Chen, and heavily but indirectly editorialize that people with dementia should not be given feeding tubes.

No they don't.
They say that the daughter with power of attorney would have to make that choice on her own judgement, with a living will her mother would have already made that choice for herself.

[Don Corleone]

No they don't.
They say that the daughter with power of attorney would have to make that choice on her own judgement, with a living will her mother would have already made that choice for herself.

They didn't say she would have already made that decision. They're asking if the daughter should make that choice for her mother, in the absence of any knowledge of her mother's wishes.

[Tribesman]

They didn't say she would have already made that decision.

Errrr...if she had made a living will then she would have ....thats the whole point of the publication Don

[Don Corleone]

They (and you, apparently) are assuming an editorial bias never evidenced.

They're saying that if she had a living will in place, the daughter would have clear grounds to pull from (or never insert) a feeding tube from/into the mother. Yet nowhere do they ever state that was the mother's wish in the first place, and it's their scenario.

You and they assume that pulling the feeding tube is the correct and only reasonable course of action, all that is required is for people to put together living wills.

I don't want a feeding tube inserted, but I made that choice on my own. If you or anybody else wants one, I wouldn't dream of denying it to you. Well, maybe you, but not anybody else...

[drone]

To be honest, killing off the old people is probably the only way we are going to dig ourselves out of the current hole we reside in.

Pros:

• Reduced Social Security payments
• Reduced Medicare payments
• Increased tax revenue from estate taxes
• Population decline in Florida

Cons:

• Political suicide

[HoreTore]

They (and you, apparently) are assuming an editorial bias never evidenced.

They're saying that if she had a living will in place, the daughter would have clear grounds to pull from (or never insert) a feeding tube from/into the mother. Yet nowhere do they ever state that was the mother's wish in the first place, and it's their scenario.

You and they assume that pulling the feeding tube is the correct and only reasonable course of action, all that is required is for people to put together living wills.

I don't want a feeding tube inserted, but I made that choice on my own. If you or anybody else wants one, I wouldn't dream of denying it to you. Well, maybe you, but not anybody else...

Uhm.

In the given scenario, where the mother doesn't have a living will, the daughter will have to make the choice on whether to insert the tubes or not. If she had a living will, the mother would've made the choice herself already. The section I highlighted in your post is just plain wrong. It's not about whether to tube or not to tube, it's about already having sorted the situation out or letting someone else make the hard choices for you while you yourself is incapable. You might want to live. Your daughter might think you wouldn't want to. Daughter makes the call, you die. With a living will, you live. That's the issue here.

Also, take a look at the question posed below the little story. The entire point of the story is to make you think. It's printed there to force you to think about hard choices. The story isn't about pulling some tubes or whatever, it's simply a story heavily biased to show that a living will is incredibly useful. And I have to say, such a bias is very acceptable.

You still haven't answered what the Bush administration's pamphlet was though...

[Don Corleone]

You still haven't answered what the Bush administration's pamphlet was though...

As far as I know, there wasn't one. Last time I checked, the Bush administration wasn't big on euthanasia and encouraging the elderly & disabled to follow the path of the noble eskimo and convincing them to go climb onto an ice flow, for the good of the tribe, so I'm not surprised.

[Kralizec]

I just skipped to the part about Lily Chen and I don't see what the problem is, either.

Lily Chen, an elderly widow, was diagnosed 4 years ago with Alzheimer's disease, a common form of dementia. Over time she has gradually been losing her ability to think clearly and make decisions. Now she doesn't remember where she is and she can no longer recognize her daughter who visits her every day. For the last 8 months, she has been completely dependent on nurse's aides to bathe and feed her. Recently, she stopped eating altogether. Her daughter has power of attorney for health care and has to decide wether to have a long-term feeding tube surgically placed into her mother's stomach. The surgery is quick and won't cause much pain, but the real issue is guessing how Mrs. Chen would value her current life. If they place the feeding tube, Mrs. Chen could live for many more years in the same or worse condition. If they don't, she will die in about 2 weeks or less, and probably won't feel hungry or thirsty.

Questions to consider:

Do you think Mrs. Chen's daughter should decide about the feeding tube based on the fact that her mother isn't eating, or based on her mother's memory problems and dependence on others for care? Why?

I don't think this has an editorial bias at all.

It's confrontational, as it should be.

[HoreTore]

As far as I know, there wasn't one. Last time I checked, the Bush administration wasn't big on euthanasia and encouraging the elderly & disabled to follow the path of the noble eskimo and convincing them to go climb onto an ice flow, for the good of the tribe, so I'm not surprised.

So.....

Basically, the Bush administration just closed their eyes and encouraged letting other people decide over whether you live or not? Yeah, that sounds just swell...

Look, Don. A living will isn't a document stating that you're to be killed when x happens. It's a document stating what you want to happen when x happens. The choice will be between living or dying. Someone will have to make that choice. Do you want to make it yourself, or do you want to place that burden on your relatives? If you want to live no matter what, and you want medical attention until you die, then you need that living will to make sure that nobody gets the wrong idea and thinks that ending treatment is the best thing to do.

X can happen. A choice will need to be made. No matter what. The only question, is who gets to make that choice. You. Or someone else.

[Tribesman]

As far as I know, there wasn't one. Last time I checked, the Bush administration wasn't big on euthanasia and encouraging the elderly & disabled to follow the path of the noble eskimo and convincing them to go climb onto an ice flow, for the good of the tribe, so I'm not surprised.

As far as I know during the Bush years they let such cases drag through the courts because people who didn't have power of attorney where challenging those that did by claiming that they knew the person better.
As far as I know the party said it was campaining on the morals of an individual case while its people were circulating memos about maximising the political capital that can be made out of other peoples problems.

[rory_20_uk]

In the land of Elves and Fairies where everyone lives perfect lives sure, infinite care for all!!!!!...

Should the fit have preference to care over those with end stage dementia? I think so. The body just hasn't realised the person is dead. Else you are denying the living treatment merely to prolong the death of those with no quality of life.

[Louis VI the Fat]

"Your life, your choices".

It can be a blessing to die.

I think it is unnatural to prolong a life with too artificial means. Modern medicine can prolong agony and misery almost indefinately. This is a problem that needs to be debated openly and frankly. Preferably, without partisanship or alarmist 'there's a democrat next to every veteran, hoping to pull the plug!'


I am very dissappointed that the Bush administration censored debate and witheld information about 'end of life' choices to the very people who need them: veterans and their families. To me, it really is 'their lives, their choices', and government should not interfere with these private matters out of its own religious or electoral agenda.

[drone]

To me, it really is 'their lives, their choices', and government should not interfere with these private matters out of its own religious or electoral agenda.

Religion and votes have nothing to do with it. Keeping people alive despite their pain or capability to enjoy life means they can be milked for every last dime. Medical-Industrial Complex

[Hosakawa Tito]

Take it from someone who has walked that walk, planning ahead for that eventuality is the best & easiest way for one's family to deal with such an emotional situation. No one should have to put up with the three ring political circus that the Terry Schiavo case turned into.

[HopAlongBunny]

The manual seems to present a reasonable range of considerations. It does make some unwarranted assumptions that could be construed as slanting the debate.

"...and probably won't feel hungry or thirsty." Oh? Apparently the author has some ability to reach beyond the veil for assertions like that.

With a little editing, it would be a very good manual.

[rory_20_uk]

The manual seems to present a reasonable range of considerations. It does make some unwarranted assumptions that could be construed as slanting the debate.

"...and probably won't feel hungry or thirsty." Oh? Apparently the author has some ability to reach beyond the veil for assertions like that.

With a little editing, it would be a very good manual.

They probably won't in end stage dementia.

[HopAlongBunny]

Sugar coating is one thing; making unsupported assertions in a manual is quite another.

I think most ppl faced with the reality of what their condition would be in end-stage dementia would say: "Gah! Just end it already"; no need to add fantasy.

[Oaty]

post removed

[Banquo's Ghost]

I'd be greatly relieved if members showed due respect for other patrons, even if they hold opposing views.

Thank you kindly.

[Beskar]

There is nothing controversial in the document, all it talks is about the freedom of choice. I am guessing to decide whether you want to live or die is too controversial to some people in itself and they want to make their choice for them. The only bias I see is the opening post, trying to invent issues, I would suspect the opening post probably copied and pasted their article from another article, saying this about it.

On an unrelated note: I support Euthanasia, anyway. It's the persons choice. I also support assisted-Euthanasia which is safe-guarded with medical experts and applied for in advance to authorities, and involves interview with a consular, making aware of other options and allowing them to decide whether or not it is the right way to go, and with the clause they can back-out at any time, even to the point the needle is inserted and they ask "Are you sure this is what you want?" before they press the syringe.

This is all about a persons choice for what they want. You either support any decisions they take, whether or not to continue living, or pass-away, or you are against allowing them to make their choices.

[KukriKhan]

Her daughter has power of attorney for health care

It sounds as if Miss Lily already made her decision: she decided to not decide, but to let her daughter do so. Presumeably, with the daughter's consent.

Do you think Mrs. Chen's daughter should decide about the feeding tube based on the fact that her mother isn't eating, or based on her mother's memory problems and dependence on others for care? Why?

That's the "leading" part; it gives only two options to the daughter for basing her decision upon. There might be any number of other factors for the daughter to consider: economic, religious, effect on the rest of the family, and so on.

[Don Corleone]

I have no objections to end of life planning. Might surprise you all to learn that I have a will in place, and my standard for taking extraordinary means is actually higher than most. My objection to the document is based on its editorial slant, as opposed to the content and material presented, a valuable service indeed.

I cited one example, but read the others. In every case, they're assuming that termination is the correct course of action, and they're offering reasons why people should feel at ease with making that decision.

Put another way, I challenge any of you to identify where in the pamphlet they offer moral support for the decision to "fight for life at any cost", which, theoretically, should be an equally valid option, no?

[HoreTore]

Put another way, I challenge any of you to identify where in the pamphlet they offer moral support for the decision to "fight for life at any cost", which, theoretically, should be an equally valid option, no?

This is a pamphlet about a living will, so that's already covered. Living wills have absolutely nothing to do with termination. It's about what to choose when you're forced to make a choice.

You read this differently to everyone else, Don. I don't see anything to indicate that the writer has a bias for termination.

[Don Corleone]

This is a pamphlet about a living will, so that's already covered. Living wills have absolutely nothing to do with termination. It's about what to choose when you're forced to make a choice.

You read this differently to everyone else, Don. I don't see anything to indicate that the writer has a bias for termination.

But that's my entire point. I object not to the information, but the way it's framed as its presented. The booklet is an endless series of anecdotes and "questions", designed to lead you to understand euthanasia is okay in case A, in case B, in case C. But what about the guy who doesn't want to be euthanized in case A, B or C? There's nothing in the booklet that supports that point of view, though this is put forward as "an objective look at end of life issues", but it's not. It's a defense of euthanasia, and if anything, hints strongly that it's the preferable course of action.

Again, for the record, I strongly believe in the Hemmingway plan. I just do NOT believe it's my right to make that decision for somebody else, or even sway somebody else to make the same decision.

[Philippus Flavius Homovallumus]

But that's my entire point. I object not to the information, but the way it's framed as its presented. The booklet is an endless series of anecdotes and "questions", designed to lead you to understand euthanasia is okay in case A, in case B, in case C. But what about the guy who doesn't want to be euthanized in case A, B or C? There's nothing in the booklet that supports that point of view, though this is put forward as "an objective look at end of life issues", but it's not. It's a defense of euthanasia, and if anything, hints strongly that it's the preferable course of action.

Again, for the record, I strongly believe in the Hemmingway plan. I just do NOT believe it's my right to make that decision for somebody else, or even sway somebody else to make the same decision.

Not treating someone who will otherwise die is not euthenasia, it's treatment stoppage.

Is there anything in there about how it's ok to administer lethal morphine doses?