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April 9, 2014

Jonathan Tobin: Why Did Kerry Lie About Israeli Blame?

Samuel G. Freedman: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Jessica Ivins: A resolution 70 years later for a father's unsettling legacy of ashes from Dachau

Kim Giles: Asking for help is not weakness

Kathy Kristof and Barbara Hoch Marcus: 7 Great Growth Israeli Stocks

Matthew Mientka: How Beans, Peas, And Chickpeas Cleanse Bad Cholesterol and Lowers Risk of Heart Disease

Sabrina Bachai: 5 At-Home Treatments For Headaches

The Kosher Gourmet by Daniel Neman Have yourself a matzo ball: The secrets bubby never told you and recipes she could have never imagined

April 8, 2014

Lori Nawyn: At Your Wit's End and Back: Finding Peace

Susan B. Garland and Rachel L. Sheedy: Strategies Married Couples Can Use to Boost Benefits

David Muhlbaum: Smart Tax Deductions Non-Itemizers Can Claim

Jill Weisenberger, M.S., R.D.N., C.D.E : Before You Lose Your Mental Edge

Dana Dovey: Coffee Drinkers Rejoice! Your Cup Of Joe Can Prevent Death From Liver Disease

Chris Weller: Electric 'Thinking Cap' Puts Your Brain Power Into High Gear

The Kosher Gourmet by Marlene Parrish A gift of hazelnuts keeps giving --- for a variety of nutty recipes: Entree, side, soup, dessert

April 4, 2014

Rabbi David Gutterman: The Word for Nothing Means Everything

Charles Krauthammer: Kerry's folly, Chapter 3

Amy Peterson: A life of love: How to build lasting relationships with your children

John Ericson: Older Women: Save Your Heart, Prevent Stroke Don't Drink Diet

John Ericson: Why 50 million Americans will still have spring allergies after taking meds

Cameron Huddleston: Best and Worst Buys of April 2014

Stacy Rapacon: Great Mutual Funds for Young Investors

Sarah Boesveld: Teacher keeps promise to mail thousands of former students letters written by their past selves

The Kosher Gourmet by Sharon Thompson Anyone can make a salad, you say. But can they make a great salad? (SECRETS, TESTED TECHNIQUES + 4 RECIPES, INCLUDING DRESSINGS)

April 2, 2014

Paul Greenberg: Death and joy in the spring

Dan Barry: Should South Carolina Jews be forced to maintain this chimney built by Germans serving the Nazis?

Mayra Bitsko: Save me! An alien took over my child's personality

Frank Clayton: Get happy: 20 scientifically proven happiness activities

Susan Scutti: It's Genetic! Obesity and the 'Carb Breakdown' Gene

Lecia Bushak: Why Hand Sanitizer May Actually Harm Your Health

Stacy Rapacon: Great Funds You Can Own for $500 or Less

Cameron Huddleston: 7 Ways to Save on Home Decor

The Kosher Gourmet by Steve Petusevsky Exploring ingredients as edible-stuffed containers (TWO RECIPES + TIPS & TECHINQUES)

Jewish World Review August 12, 2009 / 22 Menachem-Av 5769

Easing the ‘death panel’ fear

By Kathleen Parker

Kathleen Parker


http://www.JewishWorldReview.com | For purposes of civil discourse, let's assume that no one wants to kill off old people. Just as airline pilots have a primary interest in safely landing planes, even Nancy Pelosi, Harry Reid and Barack Obama will be elderly someday.


Meanwhile, we all know that America's health-care system is in dire need of repair. We also know, though we're loath to admit, that we can't do all things for all people. Technology that enables us to prolong life far beyond what is natural or desirable also threatens to cripple us financially.


How do mere humans balance the immense powers of "can" against the humbling moral quandary of "should"? This is partly what the bill's end-of-life section aims to address.


Theoretically, rational people can dwell happily on the same page. Wouldn't we all rather make end-of-life provisions voluntarily, while we're still healthy, than burden family members, who would be reluctant (one hopes) to pull the plug on our darling selves?


Of course. In practice, however, the debate is over whether these consultations are conclusively voluntary — and the bill, to the extent it is comprehensible at all, is vague enough to cause concern.


For instance, the bill makes end-of-life consultations reimbursable under Medicare every five years but allows for more frequent Medicare-reimbursed sessions should a person's condition worsen. These consultations allow for the formulation of "an order regarding life-sustaining treatment."


We can all imagine a situation when we might not want any more life-sustaining treatments — when death is imminent, for example. But we can also imagine a scenario when, feeble and ill, we might be subtly urged to forgo further life-sustaining treatment out of consideration for others. Given that "actionable medical orders" can be formulated from advance care consultations, the danger is that life-sustaining care would be precluded based on a check-mark on a document you signed five years earlier.


It would be nice to think that everything goes as patients intend, but we can safely assume that when human error collides with bureaucratic efficiency, nightmarish enforcement scenarios could ensue. Likelihoods morph into certainties when, as this bill sets out, primary-care physicians aren't necessarily involved in the consultations. As proposed, a variety of health-care practitioners would do.


Not least, the bill is an enabling document that leaves great discretion to the secretary of health and human services to develop guidelines that ultimately could change the character of what seems to be offered. In just one of dozens of examples, the bill leaves it to the secretary to develop "quality measures" on end-of-life care and advance care planning.


What might such quality measures look like? Who knows? But other documents floating around hint at what the secretary might consider.


One is a 2008 Rand Corp. report, "Advance Directives and Advance Care Planning: Report to Congress," which suggests mechanisms by which poor "advance care planning" could be viewed as "medical error," otherwise known as malpractice. While it's unclear what direction "quality measures" might take, the bill could allow the government to require Medicare providers to encourage end-of-life consultations — or risk being penalized in their compensation or in their ability to participate in the Medicare program.


Beyond the jargon, of course, the real issue is that people instinctively (and correctly) fear bureaucracy — especially in matters of life and death. When it takes 1,017 pages of mostly incomprehensible language to MapQuest the way we live (and die), people have a right to demand clarity.


A simple amendment to H.R. 3200 would do much to cool tempers. All that's needed is specific language saying that these end-of-life consultations are not mandatory — either for physicians or patients — and that there would be no penalty, either in coverage or compensation, for declining to participate.


In the absence of such language, one may reasonably assume otherwise.

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