Healthcare Reform and Advanced Directives

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Healthcare Reform and Advanced Directives
To save an individual or to not save an individual, this is the question at hand. Many uninformed Americans are up in arms over the notion of the government forcing the elderly Medicare patient to make an advanced directive. Healthcare reform as a whole has been a highly debated topic as it should be, but there are many aspects of the new healthcare reform bill that have their own energized debate. An advanced directive is one of them, but the debate should not prey upon people’s most basic fears. Up until now the topic of advanced directives had taken a back seat in the news. Prior to the healthcare reform bill, the last time advanced directives had so much media attention was the Terri Schiavo case. Wikipedia defined the Terri Schiavo case as a seven-year long legal case that revolved around whether Terri Schiavo, diagnosed as being in a persistent vegetative state (PVS) for several years should be disconnected from life support. Fierce critics and avid supporters have all stated their opinions in one form or another. The uninformed public is left to decide, who’s right and who’s wrong. I intend to explain each side, give real life examples, and educate my reader so they can decide for themselves.

Does the public really understand what an Advanced Directive is? In my experience, many patients and families do not understand. Northwestern Memorial Hospital defined advance directives as, “legal documents with written instructions regarding your medical care wishes and preferences. A living will and a medical power of attorney are important documents within advance directives. A living will describes your end-of-life wishes, whereas a power of attorney allows you to select a family member or friend, designated as an agent, as your medical decision maker.” Advanced directives indicate one’s desire for such services such as analgesia (pain relief), antibiotics, hydration, feeding, and the use of ventilators or cardiopulmonary resuscitation. The term “Advanced Directives” has become increasingly more difficult for the public to understand recently due to the terminology being flung around, for example: death panel, physician assisted suicide, mercy killing, suicide, and euthanasia. Sarah Palin is responsible for the “death panel” reference. On August 12, 2009, she posted on Facebook the following statement. “The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's death panel so his bureaucrats can decide, based on a subjective judgment of their level of productivity in society, whether they are worthy of health care. Such a system is downright evil.” The idea made popular by Sarah Palin and New York's former Attorney General Betsy McCaughey is that the government would make it mandatory for all Medicare recipients to undergo end-of-life counseling sessions "that will tell them how to end their life sooner". These so-called "death panels" would essentially be a way for our government to decide who was worthy of receiving expensive medical care and the elderly and frail would be at the bottom of that list. These poor elderly and sick people would be "killed off" if our government had their way. This claim was made by Betsy McCaughey on the Fred Thompson radio show on July 16th, 2009. This is a false claim, because a version of the bill included a provision to pay for end-of-life consultation during the patient’s initial visit (Welcome to Medicare visit) to the doctor as a newly enrolled Medicare participant, and every five years following that initial visit, or if a new diagnosis has been determined. These proposed consultations would not be mandatory and would be patient-led, meaning that patients get to choose their path of care, not the physician. Patients may refuse without any penalty, but many will bow to white-coat authority, according to Charles Lane of The Washington Post. The doctor's...
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