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UPDATED2: No, Obama's VA did NOT pull so-called 'Death Book' from website
By: David Freddoso
Online Opinion Editor
08/24/09 11:56 AM EDT
UPDATE: Earlier today, I noted that the "Your Life, Your Choices" booklet had apparently been removed from the VA site. The Department of Veterans' Affairs was kind enough to get back to me several hours after I called, in order to clarify what happened today on their website.
Spokeswoman Katie Roberts informs me that although the "Your Life, Your Choices" booklet was removed this morning from the URL I had linked to, there has been no policy change by VA. The document removed this morning had simply been hosted in the wrong place all along, on a regional part of the VA website. Links to that document should have pointed to the same document on a different part of va.gov, and it is just a coincidence that the regional copy was removed on the same day that news segments on the document aired on cable television.
Roberts said that "Your Life, Your Choices "is in a revision process in order to make sure that the document is most inclusive" of all points of view when it comes to end of life issues, and that the revision process includes faith-based and medical groups. She declined to answer for the record whether the revisions are being done because of any objectionable material in the current document.
She also declined to answer whether the VA, in its educational materials, is in the habit of posing to wounded veterans the question of whether their lives are worth living if they are wheelchair-bound or unable to control their bladder -- two of the many scenarios explored in "Your Life, Your Choices."
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Jim Towey wrote last week in the Wall Street Journal that Obama's Veterans' Affairs department had revived a controversial and previously discontinued 53-page pamphlet on end-of-life issues for wounded soldiers. The debate over what Towey calls the "Death Book" bodes poorly for the president's position in the health care debate.
We were supposed to be beyond any debate over "death panels" when it comes to health care reform. But now the administration is scrambling to explain whether and why it has been referring physicians to use an educational document for end-of-life planning that strongly hints at the worthlessness of life when its quality is diminished by, for example, being wheelchair-bound or having bladder control problems.
There are perfectly uncontroversial ways to approach the topic of advanced directives for end-of-life care. But critics are charging that this pamphlet is evidence of the government asking wounded veterans to consider the burden they are placing on their families and on society by staying alive. The question is whether bureaucrats can be trusted to handle this issue with the sensitivity it demands, and Towey, President Bush's former director of faith-based initiatives, believes this pamphlet fails that test. He writes:
"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?
The Bush Administration had discontinued this booklet's use, but Towey claimed that the VA is urging doctors to use it once again now. Over the weekend, VA Assistant Secretary Tammy Duckworth denied this, but no one in the administration has explained why it was re-posted to the Internet at some point prior to July 2, and why the VA specifically links to it as a resource for practitioners.
The booklet was co-authored by Dr. Robert Pearlman, who was among several physicians and scholars who argued in a 1996 Supreme Court amicus brief that the high court "should recognize a right to physician assisted suicide for dying patients."
President Obama is certainly not responsible for developing this booklet. Not only was it first published in 1997, but political accountability to voters would likely prevent such a thing from being done on purpose by any elected official. The bureaucracy is responsible -- and unfortunately, the same bureaucracy that ultimately coughed out this booklet will be responsible for developing cost-saving measures in health care, through the president's Independent Medical Advisory Council. "Death Panel" may be an unpleasant or even inaccurate term for what such a panel does. The VA booklet reminds us that bureaucrats are capable of almost anything.
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