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.