Home
In this issue
Feb. 8, 2013

Rabbi Berel Wein: Lofty ideals must be followed with grounded applications

Clifford D. May: Letter from the West Bank
Steve Rothaus: Judge OKs plan for gay man, lesbian couple to be on girl's birth certificate
Gloria Goodale: States consider drone bans: Overreaction or crucial for privacy rights?
Environmental Nutrition Editors: Don't buy the aloe vera juice hype
Michael Craig Miller, M.D.: Harvard Experts: Regular exercise pumps up memory, too
Erik Lacitis: Vanity plates: Some take too much license
The Kosher Gourmet by Susie Middleton: Broccoflower, Carrot and Leek Ragout with Thyme, Orange and Tapenade is a delightful and satisfying melange of veggies, herbs and aromatics
Feb. 6, 2013

Nara Schoenberg: The other in-law problem

Frank J. Gaffney Jr. : A see-no-jihadist for the CIA
Kristen Chick: Ahmadinejad visits Cairo: How sect tempers Islamist ties between Egypt, Iran
Roger Simon: Ed Koch's lucky corner
Heron Marquez Estrada: Robot-building sports on a roll
Patrick G. Dean, M.D.: Mayo Clinic Medical Edge: How to restore body's ability to secrete insulin
Sharon Palmer, R.D.: 3 prostate-protecting diet tips
The Kosher Gourmet by Emma Christensen 7 principles for to help you make the best soup ever in a slow cooker
Feb. 4, 2013

Jonathan Tobin: Can Jewish Groups Speak Out on Hagel?

David Wren: Findings of government study, released 3 days before Newtown shooting, at odds with gun-control crusaders
Kristen Chick: Tahrir becomes terrifying, tainted
Curtis Tate and Greg Gordon: US keeps building new highways while letting old ones crumble
David G. Savage: Supreme Court to hear case on arrests, DNA
Harvard Health Letters: Neck and shoulder pain? Know what it means and what to do
Andrea N. Giancoli, M.P.H., R.D.: Eat your way to preventing age-related muscle loss
The Kosher Gourmet by Diane Rossen Worthington Baked Pears in Red Wine and Port Wine Glaze: A festive winter dessert
Feb. 1, 2013

Rabbi Dr. Tzvi Hersh Weinreb: Redemption

Clifford D. May Home, bloody, home
Christa Case Bryant andNicholas Blanford Why despite Syria's allies warning of retaliation for Israeli airstrikes, the threats are likely hollow
Rick Armon, Ed Meyer and Phil Trexler Ex-police captain cleared by DNA test is freed after nearly 15 years
Harvard Health Letters: Could it by your thyroid?
Sharon Palmer, R.D.: When 'healthy food' isn't
Sue Zeidler: Coke ad racist? Arab-American groups want to yank Super Bowl ad (INCLUDES VIDEO)
The Kosher Gourmet by Nealey Dozier The secret of this soup is the garnish
January 30, 2013

Allan Chernoff: Celebrating 'Back from the Dead Day'

America isn't a religious country? Don't tell Superbowl fans!
Mark Clayton Cybercrime takedown!
Germany remembers Hitler rise to power
Israel salutes U. N. --- with the one finger salute
Sharon Palmer, R.D.: Get cookin' with heart-healthy fats
Ballot riles Guinness World Records
The Kosher Gourmet by Elizabeth Passarella Potato, Squash and Goat Cheese Gratin
January 28, 2013

Nancy Youssef: And Democracy for all? Two years on, Egypt remains in state of chaos

Fred Weir: Putin: West is fomenting jihadi 'blowback'
Meredith Cohn: Implantable pain disk may help those with cancer
Michael Craig Miller, M.D. : Ask the Harvard Experts: Are there drugs to help control binge eating?
David Ovalle Use of controversial 'brain mapping' technology stymied
Jane Stancill: Professor's logic class has 180,000 friends
David Clark Scott Lego Racism?
The Kosher Gourmet by Mario Batali The celebrated chef introduces us to PANZEROTTI PUGLIESI, cheese-stuffed pastry from Italy's south


Jewish World Review Jan. 4, 2011 / 28 Teves, 5771

They're Back! The Return of the Death Panels

By Paul Greenberg


Printer Friendly Version



http://www.JewishWorldReview.com | They were supposed to be gone. They were supposed never to have existed. Remember the foofaraw over the part of ObamaCare that was going to have Medicare finance, uh, consultations about end-of-life treatment? They soon were dubbed death panels. The name stuck, and every time advocates of the idea derided it -- untrue! fictional! absurd! wholly imaginary! -- they only gave it more currency.

Which term do you prefer, end-of-life counseling or death panels? It makes quite a difference when discussing the issue. Because when it comes to a political conflict, vocabulary remains the Little Round Top of every engagement, the strategic height that determines the outcome of the battle. And any mention of death tends to, well, kill off enthusiasm for a proposal. Whether we're talking death panels or the death tax. (Its advocates much prefer to speak of the estate tax even if it's the same thing.) Why be blunt? Especially if it's going to cost your side of the debate votes.

Awkward facts must be sidestepped, euphemisms invented. The way abortion has become Choice. Names count; what a proposal is called may determine whether it ever gets into law. And so the death panels/end-of-life consultations had to be dropped from the final version of ObamaCare, which goes by an official euphemism of its own: the Patient Protection and Affordable Care Act (PPACA) of 2009. And its Section 1233 raised concerns that the patient might be protected to death.

At the least the controversial section was sure to produce a whole new para-medical sub-specialty. For where there's a Medicare payment, payees are bound to spring up. (In economicspeak, this is called incentivizing.) What do you think the practitioners of this new art/science would be called? Nothing very precise, one can be sure. Preferably something long and latinate, a term that softens the hard edges of its meaning, something high-toned, even classical. How about thanatopsists?

You can almost see the new occupation being plugged into every top-flight medical center's table of organization. ("Thanatopsy? It's in Annex B on Level II. You'll have to take the elevator to the main floor, cross the parking lot, go through the underground garage, enter the red door and get off on Blue Level. It's simple. Just follow the signs. Be sure to bring your parking ticket, photographic ID, proof of insurance, medical records, list of pharmaceuticals, and....")

Thanatopsy. What better way for fledgling bioethicists to begin a long career of not calling things by their right names? Why alarm people by facing the facts of life, or rather death? Better to speak of end-of-life care or advance planning or, well, anything but death. Euphemism is the health of bioethics, which is never to be confused with ethics, or at least the kind explored by Aristotle or Bonhoeffer.

It's a strange thing: The very people so eager to plan for death never use the word. In any event, Section 1233 and its provision for periodic consultations about (insert appropriate euphemism here) never made it into law. Oh, death, where is thy sting, grave thy victory?

Answer: In a brand-new Medicare regulation in effect as of this brand-new year -- January 1, 2011 A.D. Issuing a regulation is always the fallback position for an administration that can't convince Congress to follow its lead. What an inconvenience it is to have to deal with popularly elected legislators anyway; they're so fickle, so sensitive, so slow to see reason ... and so accountable to the voters at the next election. Why not just work around them? Spare them the heat. We'd be doing them a favor, right?

And so it was done. Section 1233 now has been reborn as a Medicare regulation authorizing payment for "voluntary advance planning" to discuss, uh, end-of-life issues with patients and provide them with information about preparing an "advance directive" should they develop a life-threatening illness. Or well before.

With the disappearance of the old-time family doctor (and friend) in American medicine, the kind of physician who might be counted on to know a patient's condition, convictions, temperament and particular idiosyncrasies, we can now rely on experts to conduct these consultations. What a comfort. Kind of.

Don't get me wrong. There's no reason to doubt the president when he assures us in his ever-delicate way that there's nothing in his vast new health plan that "would pull the plug on grandma." These doctors, or some specially trained intern on their staff, would just ask the old lady a few questions periodically.

But as every polemicist knows, the way a question is asked can determine the answer. To quote one of those experts -- a thanatopsist? -- at the University of Michigan, someone with heart disease might be asked: "If you have another heart attack and your heart stops beating, would you want us to try to restart it?" Or someone with emphysema could be asked, "Do you want to go on a breathing machine for the rest of your life?" Or the cancer patient would be asked, "When the time comes, do you want us to use technology to try and delay your death?" As if anyone could know when the time will come, and how the patient will feel about it then. And please note the phraseology: It's not save your life, but delay your death. Never underestimate the power of negative thinking.

Life-and-death decisions that once could be safely left to the common-sense wisdom of the doctor most familiar with the patient now can be boiled down to a standard form--and a standard, billable procedure. Welcome to this Brave New World where any mention of death is banished. Just call it end-of-life. Euphemism is the first sign that you don't want to look too closely at what is being proposed.

Like a zombie who was supposed to have disappeared at the end of the first act of this drama, Section 1233 now has been revived. Even though it's taken on the form of a regulation instead of legislation. Thanks to the convenience of modern bureaucracy, all that messy business of congressional hearings and votes and open debate can be avoided just by issuing a new rule. But don't noise it about. Its modest backers have tried to keep its resuscitation as quiet as possible.

To quote an e-mail sent out by the Hon. Earl Blumenauer, a congressman from Oregon and an enthusiastic backer of this stealth regulation, the new rule represents a "quiet victory." Or as he told supporters: "While we are very happy with the result, we won't be shouting it from the rooftops. ... The longer this goes unnoticed, the better our chances of keeping it."

The surest sign of a suspect political project is that it has to be adopted as quietly as possible. In this case, quiet as death.

So those celebrating this latest advance in society's pervasive culture of death are advised to sip their champagne without making much ado about it. No sense in alarming the rubes, who tend to have this irrational attachment to life.

Paul Greenberg Archives

Every weekday JewishWorldReview.com publishes what many in the media and Washington consider "must-reading". Sign up for the daily JWR update. It's free. Just click here.

JWR contributor Paul Greenberg, editorial page editor of the Arkansas Democrat-Gazette, has won the Pulitzer Prize for editorial writing. Send your comments by clicking here.

© 2010 Tribune Media Services, Inc.

Insight (Our Columnists)

 Arnold Ahlert
 Mitch Albom
 Jay Ambrose
 Michael Barone
 Barrywood
 Lori Borgman
 Stratfor Briefing
 Mona Charen
 Linda Chavez
 Richard Z. Chesnoff
 Ann Coulter
 Greg Crosby
 Alan Douglas
 Larry Elder
 Suzanne Fields
 Christine Flowers
 Frank J. Gaffney
 Bernie Goldberg
 Jonah Goldberg
 Julia Gorin
 Jonathan Gurwitz
 Paul Greenberg
 Argus Hamilton
 Victor Davis Hanson
 Betsy Hart
 Ron Hart
 Nat Hentoff
 Marybeth Hicks
 A. Barton Hinkle
 Jeff Jacoby
 Paul Johnson
 Jack Kelly
 Ch. Krauthammer
 David Limbaugh
 Kathryn Lopez
 Rich Lowry
 Michelle Malkin
 Jackie Mason
 Ann McFeatters
 Dale McFeatters
 Dana Milbank
 Jeanne Moos
 Dick Morris
 Jim Mullen
 Deroy Murdock
 Judge A. Napolitano
 Bill O'Reilly
 Kathleen Parker
 Star Parker
 Dennis Prager
 Wesley Pruden
 Tom Purcell
 Sharon Randall
 Robert Robb
 Cokie & Steve Roberts
 Heather Robinson
 Debra J. Saunders
 Martin Schram
 Culture Shlock
 David Shribman
 Roger Simon
 Michael Smerconish
 Thomas Sowell
 Ben Stein
 Mark Steyn
 John Stossel
 Cal Thomas
 Dan Thomasson
 Bob Tyrrell
 Diana West
 Dave Weinbaum
 George Will
 Walter Williams
 Byron York
 ZeitGeist
 Mort Zuckerman

'Toons
 Robert Arial
 Chuck Asay
 Baloo
  Lisa Benson
 Chip Bok
 Dry Bones
 John Branch
 John Cole
 J. D. Crowe
 Matt Davies
 John Deering
 Brian Duffy
 Everything's Relative
 Mallard Fillmore
 Glenn Foden
 Jake Fuller
 Bob Gorrel
 Walt Handelsman
 Joe Heller
 David Hitch
 Jerry Holbert
 David Horsey
 Lee Judge
 Steve Kelley
 Jeff Koterba
 Dick Locher
 Chan Lowe
 Jimmy Margulies
 Jack Ohman
 Michael Ramirez
 Rob Rogers
 Drew Sheneman
 Kevin Siers
 Jeff Stahler
 Scott Stantis
 Danna Summers
 Gary Varvel
 Kirk Walters
  Dan Wasserman

Lifestyles
 Mr. Know-It-All
 Ask Doctor K
 Richard Lederer
 Frugal Living
 On Nutrition
 Bookmark These
 Bruce Williams