Tuesday, August 25, 2009

"Death Book" claims vs what really happens

Teach us to number our days, that we may apply our hearts unto wisdom. Psalm 90.12

These days wisdom seems in short supply in the health-care debate: to wit the August 18 Wall Street Journal article by Jim Towey where he criticizes the VA booklet, "Your Life, Your Choices," which he dubbed "The Death Book for Veterans." Towey's allegations are amply refuted in the Huffington Post's response, "How Conservatives Got the Facts Wrong on Their Latest Obsession," so I won't go into the details here. I would just like to make a personal observation about the VA.

A close family member has been a VA patient off and on for over a decade. He will be 74 next month and has been in very poor health for years. Thanks to the VA, he has had open-heart surgery, countless tests, and repeated hospitalizations for syncope, ischemia, esophageal disorders, psychiatric episodes ... I don't know the half of it. He also has dementia. His monthly expense on medications is astronomical. If it weren't for the VA, he would have died years ago.

Now I'm going to be painfully honest here: I have sometimes wondered if the VA is spending too much on him. He often refuses to follow his doctor's orders. He is unhappy because he can no longer drive, operate machinery, or work on the many projects he began before his medical problems began. He does not seem to want to live. But live he does, and at enormous public expense.

I am not an ethicist, and I find end-of-life issues confusing. I do not believe that assisted suicide is ever justified (though in some cases, one can sympathize), but face it: we are all going to die. To what lengths should we go to preserve life? When is it appropriate to withhold further intervention and make the patient comfortable? When, on the other hand, should all available medical tools be employed?

I don't know what the VA should be doing for my relative, but I do know what they are doing. They are doing everything in their power to keep him alive, and never once have they suggested letting him die. If they are erring, it is on the side of life.


Anonymous said...

Congrats on getting this on the Sojourners site. Thanks for helping the rest of us sort out the rumors, lies, facts, etc.

Diane said...

Of course, we worry that any "cost cutting" at the end of life will be used disproportionately against the poor -- and will put people under pressure to end their lives early.

LaVonne Neff said...

We always need to look out for the concerns of the poor--but I would point out that my relative has no income beyond his small disability check. Right now the poor who do *not* have a government-subsidized medical program like VA or Medicaid are the ones we need to worry about, because private enterprise is not taking care of them adequately. My relative's wife, for example. She is unable to get insurance, and though she is probably diabetic, she cannot afford medical care.