Scaring seniors: Reform opponents spread myths about euthanasia

Aug 4, 2009 3:16 PM

Misinformation campaigns about health reform are sparking up across the political spectrum. The one I’ve found most shocking is the notion that reform would somehow lead to the routine euthanasia of senior citizens. Last week, Politico asked the question in an article titled, “Will proposal promote euthanasia?” And at an event with AARP last week, a woman posed this question to President Obama:

“I have heard lots of rumors going around about this new plan, and I hope that the people that are going to vote on this is going to read every single page there. I have been told there is a clause in there that everyone that's Medicare age will be visited and told to decide how they wish to die. This bothers me greatly and I'd like for you to promise me that this is not in this bill.”

Obama assured the woman the rumor was false. It is.

So where did the rumor come from?

It appears to have started with Betsy McCaughey, a former Lieutenant Governor of New York, and the current chair of the Committee to Reduce Infection Deaths. In a radio appearance on July 16th, McCaughey said "Congress would make it mandatory — absolutely require — that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner," according to PolitiFact.com, a website of the St. Petersburg Times, which thoroughly debunked the charge. She went on: “The bill expressly says if you get sick somewhere in that five-year period, you have to go through that session again—all to do what is in society’s best interest or your family’s best interest and cut your life short.”

Despite being demonstrably false, those comments were picked up and exaggerated across the talk radio, TV, and the Web.

McCaughey sited page 425 of the House health care bill, which includes a section, titled "Advance Care Planning Consultation*." That (rather minor) section of the bill explains that Medicare under the new proposal would pay for counseling sessions about end-of-life care every five years, or more often for people with severe illness or terminal conditions. That service is currently not paid for by Medicare. But the proposal would not make such services “mandatory,” or “absolutely require” them. It would remain a voluntary decision, as it is now, between patient and doctor whether to have such discussions.

The counseling sessions about end-of-life care are designed to cover topics like advanced directives (your preferences for care in the event you are ill with no prospect of recovery and unable to express your wishes); health care proxies (someone empowered to make decisions for you when you cannot); and living wills. These are important matters that all Americans should consider with their doctors. They have nothing to do with euthanasia, which is illegal in most states, or with healthcare rationing.

The Agency for Healthcare Research and Quality says that patients need more effective advanced care planning. AHRQ studies have shown that seniors who discuss advance care planning with their doctor and family are more satisfied with the care they receive and have less fear and anxiety. They feel that they have a better ability to influence their care, and believe that physicians have a better understanding of their wishes.

Despite the importance of advanced care planning fewer than 50 percent of severely or terminally ill patients studied by AHRQ had an advance directive in their medical records. And just 12 percent of patients with an advance directive had talked with their doctor while developing it.

Likening this needed healthcare service to euthanasia is inaccurate and irresponsible. We have long advised patients with severe or terminal illnesses to have such conversations with their doctor. For more, see our tips for coping with a complicated system.

—Kevin McCarthy, associate editor

*links to PDF; Photo courtesy of pedrosimoes7