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Berwick, Right-to-Die Groups, and Political Mumbo Jumbo

By Angela Morrow, R.N.
Palliative Care Blog

According to the website The Hill, a Republican memo charges the Obama administration with avoiding questions regarding its new head of Medicare’s ties to the health care industry, specifically to right-to-die organizations.

“The memo said Grassley, the ranking member of the Senate Finance Committee, which has jurisdiction over Medicare, was also waiting for responses to questions to Berwick about whether he had links to a group that advocates for patients’ right to die. The question came from another Republican member and was based on Berwick’s past statements on end of life care, not any tangible proof that he was linked to Compassion and Choices, the former Hemlock Society.”

There seems to be concern from Republicans that Berwick is jumping on the “death panel” bandwagon and will support euthanasia. I would like to remind readers that “death panels” do not happen now and won’t happen in the future. If worried Republicans would take a little time to research Compassion & Choices, they would see that this is not an organization that promotes euthanasia. Compassion & Choices works to expand choices at the end of life, which includes physician-aid-in-dying, but that is a far cry from euthanasia.

The problem with using end of life choices as a political platform is that politicians rarely get the facts straight. End-of-life discussion turns into “death panels”; Physician-aid-in-dying (AKA Physician-assisted suicide) turns into “euthanasia”. Dying is increasingly becoming something that is not seen as natural. More and more, groups and individuals who advocate for personal choice at the end of life are portrayed as wanting to “kill” people. Death is becoming a politically charged topic when politics should never be involved in something so personal.

Unfortunately, what happens when death becomes so political is that groups and individuals go to extremes to make sure their right to choose is honored. Enter the Final Exit Network (FEN). I’ve taken some heat from FEN supporters and received emails from FEN employees regarding my profile of the network and my blogs about their advertisements. I’ll clarify here that I fully support an individuals right to choose how they die. I believe it is vitally important to consider things such as where you want to die, what medical interventions you do or do not want, how you want to be treated, and who you want present when it happens. I support the work of groups such as Compassion & Choices who advocate for state physician-aid-in-dying laws for terminally ill patients and support physicians working in pain and symptom management. On the other hand, the Final Exit Network has gone to extremes to help patients who are NOT terminally ill because there are so many individuals who feel like this is the only way to preserve their dignity. When people feel threatened that the government will decide the most personal aspects of their lives, many take matters into their own hands. However, an organization that helps non-terminally ill patients commit suicide does damage to the public’s view of right-to-die organizations and threatens the work of hundreds of individuals.

I propose that the focus of Berwick’s appointment as head of Medicare shift to how he will work to preserve hospice care. What will Berwick do about the proposed cuts to the Medicare Hospice Benefit? How will he ensure that terminally ill patients have access to quality end of life care? Let’s leave the actual act of dying to the individual and get government out of the way.

Profile of the Final Exit Network

Profile of Compassion & Choices

The Death Panel Debate