Pushing One-Way-Streets In End-of-Life Care

Articles like this are ubiquitous these days: First, purportedly write about one thing that is entirely reasonable—but which, beneath that patina, is really about centralizing health care decisions and/or restricting expensive treatments, e.g. rationing.

Yesterday I deconstructed a NYT opinion column that supposedly was about how we don’t know which patient will die before giving expensive care—very true—but actually urged removing decision making in such cases to a centralized bureaucracy.  Today, we have an article in the LA Times that urges us to all sign advance directives so we won’t receive onerous and expensive interventions that we don’t want—fine and good.  But it is really promoting the meme that ”society” will have to prevent us from receiving such care if we want it.  From “Having to Think About the Unthinkable” by Steve Lopez:

It’s understandable. Nobody wants to think in advance about life ending. In our satisfied state of denial, we want to believe medical advances will keep us healthy until we die in our sleep at a ripe old age. But death doesn’t always come on our terms, and failing to face up to other possibilities can put crushing burdens on loved ones — not to mention that soaring end-of-life medical costs are at the center of the national budget crisis.

“We use healthcare resources far out of proportion to any other country on the planet,” said Wenger, who researches elder care for the Rand Corp. “We need to have a conversation about where society wants to put its resources [and we] might decide there are certain kinds of life extension that are not as important to us as educating kids and having adequate infrastructure.” Of course, none of us individually can solve all of these societal issues. But there are things we can do to make our own situations better at the end of life.

Than why bring the “societal issues” up?  They are irrelevant tp merely urging people to create advance directives and educating them about some of the things to think about in that regard.

But the ultimate point isn’t “choice,” rather, it is softening us up for the coming restriction on our choices.  We are actually being told that the decision really shouldn’t be ours to make if we want expensive treatment that will leave us unproductive.  But that iron fist is wrapped in the velvet glove of an otherwise relatively uncontroversial text—and many of us don’t notice.  But then, that’s why I’m here.

Pay close attention to the columns and articles about end of life care that deploy this little slight of hand.  If you want, send them to me and I’ll try to post about them.

We are being set up for medical “choice” as a one-way street. I wrote about that  meme 10 years ago in Culture of Death.  But the push is accelerating in the wake of the passage of Obamacare.  And the galling part is they wrap the authoritarianism with a bow and pretend to be doing us a favor.