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Dignity & Choices 

  Don't delay - Register today!  

Compassion & Choices is proud to present DIGNITY & CHOICES, a symposium on End-of-Life Advocacy, October 13-14, 2009.

Conveniently held at the National Press Club in Washington, DC, the symposium is a must-attend event for all those engaged in health care and its reform. Dr. Elmer Huerta, former president of the American Cancer Society, America’s favorite ballet dancer Jacques D’Amboise, and New York Times columnist Jane Brody will make plenary presentations. Learn more about symposium presenters here.

Separate tracks will cover Politics and Policy; Medical Care and Mental Health; and Culture.
With health care reform now moving through Congress, attending DIGNITY & CHOICES in October will put you in touch with what the future holds for end-of-life care.

Full symposium agenda available online here.

  Facebook is the world’s
largest online social network:
over 150 million active
users. Many organizations use Facebook to keep members informed and updated as well.

Now the nation’s largest advocate
for end-of-life care and choices- Compassion & Choices-
is on Facebook!

  We share special information, advocacy updates and tools with our Facebook group members.

To join, go to Facebook.com and sign up for a free account. Click here to find our group page and then click “Join this group”.

That is all it takes to be plugged in to Compassion & Choices on Facebook!

In The Media

Compassion & Choices
PO Box 101810
Denver, CO 80250-1810
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www.compassionandchoices.org

 


Copyright Compassion & Choices 2009

In This Issue

• Compassion & Choices Works for Health Care Reform
  

  As the battle proceeds over health care legislation; Compassion & Choices works to make patient choice a key part of reform.

• Dignity & Choices
  

  Find out what health care reform will mean for end-of-life advocacy at Dignity & Choices, an international symposium in Washington, D.C. Full symposium agenda and registration available online at http://www.compassionandchoices.org/symposium.

• On My Mind by Barbara Coombs Lee
  

  Opponents of health care reform are eager to kill legislation and fear is their favorite weapon. Their newest scare tactic, oddly, is the threat that patients will be able to make choices about the end of their lives.

• All in the Circle of Life    Jan Corey Arnett
  

  Compassion & Choices recently invited submissions for its first annual Storytelling Contest. The touching account of the conversations Jan Corey Arnett had with her dad in his final days of life is our first-place winner.

• Montana Supreme Court to Hear Oral Arguments September 2nd
  

  The Montana Supreme Court announces an early date for oral arguments over the landmark decision in Baxter v. Montana.

• In the Media

Media highlights on end-of-life issues.

Compassion & Choices Works for Health Care Reform

As the battle proceeds over health insurance reform, Compassion & Choices is working hard to make patient choice at the end-of-life a key part of reform. With AARP and a multitude of other organizations at our side, we are fighting to gain Medicare coverage for comprehensive end-of-life consultations. End-of-life issues are now on the map in Congress.

On June 19, 2009, Compassion & Choices hosted a federal congressional staff briefing about the Life Sustaining Treatment Preferences Act, introduced by Rep. Earl Blumenauer (D, OR), authorizing Medicare reimbursement for physicians’ consultations with patients about end-of-life choices.The room was very full, standing room only, with close to 60 attendees. The panel included Jennie Chin Hansen, R.N., M.S., F.A.A.N., AARP President, our own Director of Legal Affairs Kathryn L. Tucker, J.D., and Howard Tuch, M.D., American Academy of Hospice and Palliative Medicine (AAHPM). 

This panel put Compassion & Choices squarely beside two very mainstream groups. Compassion & Choices received additional (unexpected!) validation when AARP President, Jennie Chin Hansen, acknowledged the important work Compassion & Choices has done to improve pain care, specifically the great success in the Bergman case, establishing inadequate pain management as a form of elder abuse.

By July, the Life Sustaining Treatment Preferences Act had picked up co-sponsors from both parties and been folded in to a broader health care package being considered by the House Ways and Means Committee.  More than 1,600 Compassion & Choices supporters contacted members of the House Ways and Means Committee, urging them to support Medicare coverage of the end-of-life discussion. Your voices were heard loudly and clearly and on July 16th, the Committee passed the Medicare provision without weakening or amending the language.

Then, sensing health insurance reform was at last approaching, reform’s opponents seized on the bill as something they could twistt into a source of confusion and fear. Launching a campaign of misinformation, anti-choice extremists and their allies in Congress began attacking this critical provision, claiming it would promote euthanasia and cause the murder of elders. While nothing could be further from the truth, the distortion has been repeated again and again in publications, in a barrage of comment from bloggers and in statements on the floor of Congress.  Once again, with your help, Compassion & Choices is in the vanguard to refute these lies and tell the truth that the provision offers a voluntary benefit, the opportunity to talk with your doctor about end-of-life choices.

To keep up with the latest news and seize opportunities to shape the debate, visit the health care reform page on our website and sign up to receive action alerts. Contacting legislators, commenting on blogs, writing letters to the editor and calling in to talk radio shows are all important to present the truth and convince leaders of the importance of talking about end-of-life care.

With your help, Compassion & Choices is part of a great advance in end-of-life care, building upon several years of thoughtful and strategic groundwork. 
 

On My Mind
by Barbara Coombs Lee

Who Is Against People Making Their Own Health Care Choices?

Opponents of health care reform are eager to kill legislation and fear is their favorite weapon. Their newest scare tactic, oddly, is the threat that patients will be able to make choices about the end of their lives.  For over a decade, Compassion & Choices has been improving care and advocating for patient choice at the end of life (most Americans agree that’s a good thing).

Writers in the Wall Street Journal and Forbes Magazine, a barrage of comment from bloggers in opposition and statements from GOP leaders all condemn a small section in HR 3200. That provision provides Medicare reimbursement for doctors to talk with their patients about their wishes for end-of-life treatments like feeding tubes and artificial ventilators. Commentators tell a scary story about how these conversations are “required every five years” and will “push seniors” toward a decision to shorten life.

These claims are false. The only thing required is that Medicare reimburse, once in a five-year span, doctors who have this vital conversation with their patients. Consulting together, the doctor will learn the patient’s Advance Directive wishes, and together they might prepare a Physician’s Orders for Life-Sustaining Treatments (POLST). Making a conversation a covered benefit might encourage doctors to bring up the subject. Is that a bad thing?

Most of the people I know would be thrilled to have their doctor ask about their values, beliefs and preferences for care. Some patients might decide they’d like to die peacefully if they are terminally ill or permanently unconscious. Another patient will decide to utilize every kind of life-sustaining therapy as long as medically possible.  The conversation protects either decision.  The purpose of talking about these things is simply to empower people and make sure their wishes are heard.

If Medicare pays doctors to discuss choices with seniors, will doctors coerce them into an early death, as Representative Boehner claims? Only someone with a deep distrust of doctors caring for their patients or seniors choosing for themselves would believe this. Paying a doctor to have this conversation with patients empowers the patient and offers them choices. The real scary story is what can happen when a person falls into a persistent vegetative state and no one knows what choice they would make if they could still speak for themselves.

The thought of becoming empowered with information and the ability to make health care decisions for ourselves does not scare people. Studies show patients want that information. What scares us is the thought of being trapped in a situation where OTHER people, perfect strangers — maybe even politicians — might take our choices away and make decisions for us.  

Most people believe individuals themselves are the best decision-makers when it comes to these very personal, private health care choices. In November 2005 Pew Research Center found a whopping 84% of Americans approve of letting patients themselves decide about extraordinary treatments to prolong life.

Many seniors have a “living will” expressing their preferences (and people of any age could find themselves unable to speak for themselves). Why is coverage for this conversation important? Laws vary from state to state. Having specific documents in order may be necessary to make sure your wishes are carried out and that the loved one you would choose is empowered to act on your behalf (In New York, for example, a spouse or other family member does not have that power unless they are documented as your health care proxy).

Re-enforcing your decision by discussing it with your doctor makes it more likely your wishes will be followed. Solid research shows that people who talk with their doctor about end-of-life wishes are more likely to have those wishes honored, and more likely to experience a peaceful, pain-free death when the time comes.

This legislation encourages communication, promotes choice, compensates doctors for important care and empowers patients. Opponents of health insurance reform won’t be able to derail a bill by scaring people with the right to make their own important life decisions.

Compassion & Choices' Storytelling Contest Winner

Compassion & Choices recently invited submissions for its first annual Storytelling Contest. Many moving stories of high quality were sent for he contest, designed to help Compassion & Choices share the stories of people from across the nation.  

We are excited to announce our first-place winner, Jan Corey Arnett, of Battle Creek, Michigan. "All in the Circle of Life" is a beautifully written and touching account of the conversations Jan had with her dad in his final days of life will also be published on our web site and in the summer issue of Compassion & Choices Magazine, due to hit mailboxes in late August. 

All in the Circle of Life
Jan Corey Arnett

My father was a hard-working farmer who did everything to the best of his ability whether it was tending crops, milking cows, helping neighbors, or caring for his family. The youngest of five daughters, I spent as much time with Dad as I could. He taught me to drive a tractor, ride a horse, and recite poems like, "Simon Slick's Mule" and "My Pa." He loved to share stories of Bobby, his favorite childhood pet; and to enjoy good visits with Charlie, a longtime friend.

Dad was in his early 70s when his prostate cancer was found and near 80 when we learned it had spread to his spine. After the many times he'd come within a breath of death as a farmer, he didn't fear it even when death was staring him in the face without looking away. What bothered Dad the most was leaving the family he loved.

Conversations about the death of someone you love aren't comfortable, especially when it is the someone you love who is doing the talking. But at the same time, there was a certain rightness and relief when Dad conveyed his desires about that dreaded time.

He hoped he could die at home with family around him and then be whisked away wearing his favorite blue sweater and ordinary work pants. He didn't want a chunk of granite marking his grave. He said he'd picked too many stones on the farm in life to want any near him in death. In fact, he didn't want to be buried at all. He wanted to be cremated and have his ashes scattered under the shade of a grove of fragrant cedar trees he and Mom had long admired.

If anyone had told me that as my father approached death, I would have the strength and calm to sit at his bedside, bend low to his ear, and recite his favorite poems in a steady voice, I would have told them they were wrong as wrong could be. Not me. The thought of losing him was incomprehensible. But Mom, my sisters and I, with his hospice team, kept him as comfortable as possible. Medications eased the suffering, movement with our hands massaged the energy field above his bed, and calm reassurances — that when he chose to move on to the next step in his circle of life it would be okay, because we would take care of one another — eased the anguish. For him most of all, we prayed.

One afternoon, when I was alone with Dad, he rested with his eyes closed but began to caress the air beside him on the bed as if stroking the fur of an invisible pet. "Daddy, is Bobby with you?" I asked, to which he nodded, "Yes," as a smile creased his lips. Later, he opened his eyes, raised a weary arm, and looking toward the door, waved slightly. Then, in a clear strong voice he said, "I'm ready!"

"Is Charlie here, Dad?" I asked, knowing the words had come from intelligence far greater than my own. Again, he nodded. His friend Charlie had been gone for years, but had visited Dad in a dream to say he was waiting for him. Now, he came in spirit form to accompany my father on a journey to a new beginning.

Dad set off for that journey just days later. The night he left, my sister Sue had to return to her job in Virginia, knowing that his time was very near. When she called from an airport between flights, she didn't ask how he was doing, instead she said quietly, "Dad died just a little while ago, didn't he? I felt his spirit."

Sue is gone now too, taken by breast cancer little more than a year ago. She too made her wishes known about death with dignity, similar to Dad's in many ways. As she departed in the night, she sent a message by way of a dream. In the dream her voice was on my telephone answering machine. "Jan," the message said, "I just called to tell you that I love you."

Sue's ashes, like Dad's, nurture the Earth at places she loved - a children's garden, the cedar grove, a place along a Michigan river. And her spirit, like Dad's, knows life anew. Losing them was sorrow. Treasuring having been a part of their lives is joy. Trusting that I will be with them again is anticipation.


Jan Corey Arnett, a lifelong Michigan resident, was born on a farm in the Upper Peninsula. She’s passionate about life and nature and writing is her love.

Montana Supreme Court to Hear Oral Arguments September 2nd

The Montana Supreme Court will hear Oral Arguments September 2nd in Helena, in the landmark case of Baxter v. Montana.  The Court will consider whether to uphold last December’s ruling from First Judicial Court Judge Dorothy McCarter, that the choice of aid in dying is protected under the Montana Constitution’s guarantees of privacy and dignity.  The Appellees are represented by Compassion & Choices Legal Director Kathryn Tucker and well-known Missoula litigator Mark S. Connell.

A broad, diverse group of organizations and individuals filed friend-of-the-court briefs in June in support of Appellees, urging the Montana Supreme Court to uphold the lower court ruling that terminally ill Montanans have the right to choose aid in dying. Medical associations, civil liberties and human rights organizations, bioethicists, religious leaders, constitutional law experts, family members of Montanans who wanted aid in dying but could not choose it,  and thirty-one Montana State legislators filed briefs arguing that the State Constitution's guarantees of privacy and dignity include the right to aid in dying.

Briefing will be completed in late August. Compassion & Choices Legal Director, Kathryn Tucker, noted:  “For the court to schedule oral arguments so soon after the briefing is concluded is unusual. This suggests the Court is eager to address this important issue. ”  Tucker is optimistic that the Montana Supreme Court will extend its robust privacy jurisprudence to this profoundly personal choice. Should the Court do so, it would be the first state in the nation to recognize state constitutional protection for this choice.