Monday, August 24, 2009

Life Not Worth Living? The Obama Administration Thinks So – at Least for Veterans

We have a rule in our family: Whenever we see members of the US military, we stop, shake their hand, and thank them for their service. As a naturalized citizen, I add my own piece: The United States has offered me immense opportunity that even as a (then) privileged white South African, I could never have had, and that it is the service of our military that has kept me safe and free to pursue the American Dream.

However, it’s getting difficult to keep thinking that our government actually appreciates our veterans just like my family does, after reading the Veteran’s Administration’s (VA) end-of-life booklet, “Your life, Your Choices.”

The document, written by the Clinton Administration, was later withdrawn by the Bush Administration, but it’s been in play since being reintroduced by the Obama Administration this past February.

With some parts of the media beginning to sniff around the document, the Obama Administration, trying to head off another PR disaster, today hastily added a note to the booklet’s webpage (the page has since disappeared altogether):

The document is currently undergoing revision for release in VA. The revised version will be available soon.

Nonsense. The administration got caught on the wrong foot, when somebody noticed what it really thinks of the value of Vet’s lives - as policy, in black and white, for everyone to see.

It’s a disturbing document, because woven among many paragraphs that are informative and clear, is the rather ominous notion: Veteran’s lives might, at some point, no be worth living.

Yes, you read that correctly.

A powerful branch of the Obama Administration, the VA, is now clearly in the business of helping citizens decide whether they should live or die.

Lest I be accused of “fishy thinking,” let’s go to the actual document, p. 21, where your government asks our sick veterans:

What makes your life worth living?

Think I’m stretching things? Read on.

After asking this question, What makes your life worth living?, the document tries to “help” Vets answer it. To do this, the VA thoughtfully provides a series of sub questions to be answered on a scale from

Difficult, but acceptable, to

Worth Living, just barely, to

Not worth living.

Here’s a sample of the sub questions to be answered through the scale above:

d. I am in severe pain most of the time.

p. My situation causes severe emotional burden for my family (such as feeling worried or stressed all the time).

q. I am a severe financial burden on my family.

I am not making this up.

Go just two pages later to the section entitled “Hope of Recovery” (p. 23). Here the quality of life issue is raised again in terms of chances for recovery from a serious illness.

(Sidebar: It doesn’t say a terminal illness, just that you won’t get back to where you were before your turn for the worse):

Imagine that you are seriously ill. The doctors are recommending treatment for your illness, but the treatments have very severe side effects, such as severe pain, nausea, vomiting, or weakness that could last for 2-3 months.

I would be willing to endure severe side effects if the chance that I would regain my current health was:

high (over 80%) [Yes, Not sure, No]

moderate (50%) [Yes, Not sure, No]

low (20%) [Yes, Not sure, No]

very low (less than 2%) [Yes, Not sure, No]

There's plenty more of the same in its 54 pages.

It's not unreasonable, based on the document, to observe at least some of the Obama Administration's thinking:

1. Life is not always worth living.

2. We can help you decide if life is not worth living.

3. Your life might not be worth living because your being alive may be a burden to others.

4. Your life might not be worth living because some treatments are painful, have side effects, and might only provide a small chance of “getting healthier.”

There have been other governments who have defined groups of their citizenry as having lives not worth living.

Is the current administration populated by a bunch of Nazis? No, the only people who were Nazis were the Nazis.

However, there’s no question that our government, at least as far as its war heroes go, officially acknowledges that under a whole bunch of circumstances, some citizens’ lives might not be worthy of living.

I wonder which group will be next?

Because, for governments unchecked, there’ll always be a next group, trust me.


Single Dad / Disabled Daughter said...

I must say that in one sense the Administration is right, sometimes life is not worth living. BUT, that decision must lie with the individual and the individual alone. If the individual cannot communicate and/or understand the situation, then others MUST err on the side of determining that said life IS worth living.

There will always be those trying to make that determination for others.

Jude said...

Wow, this is not surprising, but it still stinks. There is stuff on that list like - If you have to rely on a feeding tube is your life worth living? and If you are incontinent is life worth living?

That is just so far off the wall I just can't even imagine. My daughter just got rid of her feeding tube, after 8 years, and she has been, and will be, incontinent, not in control of her bowels, and a whole list of other stuff that apparently some people feel is a reason to not want to live anymore. That is so ridiculous I can't even believe it. And they're pushing these ideas - disgusting!

After someone reads that what do you think they think about the next time they see someone in that "condition"? Well, they won't be thinking "What a happy person. They sure have a great life". They'll be thinking "That poor thing. Someone should put them out of their misery." Just what we need!

Dr. Mark Mostert said...

Thanks so much for the comments, there's no doubt that many people find themselves in some very tough positions.

Yes, I think we always need to err on the side of life, and I'm pretty sure that if any government decides these issues, people will be destroyed as a matter of policy.

Keep up the good work!!

David said...

Dr. Mostert,

A colleague suggested I comment. First let me say that I admire you for dedicating your life to disability issues. As someone who has family and friends with severe disabilities, I applaud anyone who is a champion for their rights and dignity.

Because that issue is so very critical, and so sadly overlooked, I am saddened by the fact that you would distract from it by posting politically-motivated partial information and scare tactics.

An apolitical read of the entire document you reference would see it for what it is: an attempt to help people in a difficult situation. Imperfect, yes, as most things created by any government are, but certainly not a call to ask veterans to end their lives early.

I have had family members and friends who struggle terribly with trying to determine what their loved one's wishes are when that loved one cannot communicate and has not made clear their wishes in advance. This decision belongs to the individual alone.

I feel like you are trying to take advantage of the momentum caused by the absurd "death panel" allegations by manufacturing outrage at document that is not outrageous. Disabled veterans, who so surely deserve our deep respect, should not be made pawns in partisan bickering.


Anonymous said...

After reading the document, I have to respectfully disagree with your opinion. It is not meant to say who has a life that is and is not worth living, but meant to get people to think about these types of decisions before the time comes. I found the booklet informative and thought -provoking.