Dispatches from the Creation Wars

OMG! It’s the Death Book!

Fresh off the heels of their last successful piece of demagoguery — death panels in the healthcare reform bill — the right wing brings you their latest and greatest lie: The Death Book. Not only does the Obama administration want to kill grandma and Sarah Palin’s baby, they also want to convince veterans to kill themselves. That was the meme being pushed by Fox News last weekend.

The demagogue in chief on this one was Jim Towey, who started all of this last week with a highly dishonest op-ed in the Wall Street Journal where he claimed that the VA has a book called Your Life, Your Choices (full text here) that tells veterans that they’ve become a burden on society and should kill themselves. The lies came fast and furious:

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.”

But as David Weigel notes at the Washington Independent, the VA did not suspend the book under Bush. A single local VA hospital removed the book from its website, that was all. The book was in full use throughout the Bush administration, which makes all of this new feigned outrage all the more idiotic.

Towey claims that the book was written to convince veterans that they’re a burden on society and should kill themselves rather than fight to stay alive:

“Your Life, Your Choices” presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political “push poll.” For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be “not worth living.”

The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to “shake the blues.” There is a section which provocatively asks, “Have you ever heard anyone say, ‘If I’m a vegetable, pull the plug’?” There also are guilt-inducing scenarios such as “I can no longer contribute to my family’s well being,” “I am a severe financial burden on my family” and that the vet’s situation “causes severe emotional burden for my family.”

When the government can steer vulnerable individuals to conclude for themselves that life is not worth living, who needs a death panel?

This is nonsense. Yes, the book lists all of these possible situations and more. Why? Because the whole point of the book, which is subtitled “How to prepare a living will,” is to get people to think about such situations in advance, before they actually happen, so that they can talk about it with their families and decide what they want done before they become incapacitated and can’t make their own decisions.

The notion that the book pushes people to kill themselves is absolutely ridiculous if you’ve actually read it. In fact, the book goes to considerable effort to caution people against believing themselves to be a burden casually:

It’s normal for people with new limitations to feel like they are a burden because they need more help from others. But be sure to ask your family members what it means to them to be a burden before you “spare” them. You may be taking away their chance to return the gift of the love and care that you’ve given them.

It also warns patients against making a hasty decision, noting that sometimes the immediate negative reaction may give rise to depressed feelings that will pass over time:

People often think that if they had physical or mental limitations their life
would be terrible. But some people adjust to limitations and disability and find that life still has a lot to offer them. After you’ve given yourself some time to get used to your new
situation, take another look at the exercise on page 21 to see if your thoughts have changed about what makes life worth living.

This book is extremely valuable. Far from encouraging suicide, it encourages people to think deeply about end-of-life considerations while they’re still able to think about them clearly, discuss them with their loved ones and make sure everyone understands their wishes.

This is a personal issue for me. I’ve been in this situation three times with loved ones, having to help make decisions on what to do at the end of someone’s life that I loved deeply. In all three situations, the decision was made to withdraw the last vestiges of medical care that was keeping their body barely alive and let them die. In all three cases, there is no doubt in my mind that this is what they would have wanted. In two of three cases, they had made that wish very clear themselves while they were still able to do so.

I am appalled and offended by people using such painful and difficult situations for political gain. Even worse that they do so with lies and by attacking resources like this book and the consultation provision in the health care reform bill that would help people express their own wishes in advance and encourage them to think about them before they happen so they can make living wills and ensure that their own wishes are followed.