Skip to comments.Full Text of the House Dem "Advanced Care Planning" end-of-life consultation
Posted on 08/09/2009 10:35:59 AM PDT by Jeff Head
I have had many questions and comments regarding the PDF file of the House Democrat Health Care plan I made available for download on my site, HERE.
Most are, as am I, appalled at the plan and the wording of it...particularly when taken in context with the cited quote and views of the chief architect of the plan, and chief advisor to Obama on Health Care and Policy advisor to the Democratic Congress on HEalth Care, Dr. Ezekiel Emanuel, HERE.
Some however attempt to rationalize, or even make statements regarding the plan that just are not there, are not supported (at least IMHO) by fact, and certainly are at odds with the views openly stated by the chief advisor who has helped craft the plan.
This is particularly true when it comes to the end-of-life counseling portion of the plan identified pn page 425 of the plan where it amends the Medicare laws and thus applies to seniors over the age of 65.
So, I thought I would post the wording of that section, directly from the plan, but formatted so yuou can follow it. People need to make up their own minds.
The way I read it, the section makes the sessions required, it brings government bureaucrocy into life planning where the individual, the Dr. and family should make the sole decisions, and it open up the possibility for government health orders regarding the end-of-lie treatment of the elderly.
Far, far too much government involvement and power, particularly given the clear eugenics and infanticide reasoning of the auther.
Here it is. You decide.
Advance Care Planning Consultation
(hhh)(1) Subject to paragraphs (3) and (4), the term advance care planning consultation means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:
-----(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested peo1ple to talk to.
-----(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.
-----(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.
-----(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).
-----(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.
-----(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include
----------(I) the reasons why the development of such an order is beneficial to the individual and the individuals family and the reasons why such an order should be updated periodically as the health of the individual changes;
----------(II) the information needed for an individual or legal surrogate to make informed deci-sions regarding the completion of such an order; and
----------(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a health care proxy).
--------(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State
----------(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and
----------(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
--------(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that
----------(I) ensures such orders are standardized and uniquely identifiable throughout the State;
----------(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professionals authority under State law) may sign orders for life sustaining treatment;
----------(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and
----------(IV) is guided by a coalition of stakeholders includes representatives from emergenc medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.
(2) A practitioner described in this paragraph is
(A) a physician (as defined in subsection (r)(1)); and (B) a nurse practitioner or physicians assist1ant who has the authority under State law to sign orders for life sustaining treatments.
(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1).
(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program.
(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order.
(5)(A) For purposes of this section, the term order regarding life sustaining treatment means, with respect to an individual, an actionable medical order relating to the treatment of that individual
I see nothing in this wording that makes these "sessions" elective and voluntary.
Sorry, my bad.
BTW----------Where in the HELL is tort reform withing the 1000 plus pages of this tome from the depths of hell?
Do you mean the actual WORDING of ‘death panel’? OF COURSE those words are not in the plan....the death panel refers to the statistics that will be set that determine who has a nice enough quality of life, determined again, by the death mongers, to earn a few more years of life using equipment needed to support that life. IE...are those dependent on that expensive ozygen contributing members to society, etc.
Sounds peremptory to me.
In case anyone is in doubt as to the meaning of this phrase--it is an Orwellian bureaucratic device to refer to orders ending life, not sustaining it. Things like "no heroic measures," "palliative (comfort) care only" and the alltime fave, "Do Not Resuscitate."
is guided by a coalition of stakeholders includes representatives from emergenc medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association
There is no problem with people doing this for themselves, with their Doctor, you know, the one they chose, and their familites...it's when statists and others want to interject government and their "complete lives" calculations and government bureaucrats and "stake holders" that is the issue.
With me and most people I know.
Here's a clue. If you want top consult with the government on your end of life issues...knock yourself out. But don't try and force it on me and mine or most folks I know.
My mother has severe diminsia. She's 84 years old and we take care of her and get her the treatment she needs. Ezekiel believes such people should not get any treatment.
We have done this for five years and my mother has interacted with her great grandkids...and they with her. Government will not deprive me of that experience as long as I draw breath. God may...and I have faith in Him and His timing and control of such matters. But not the governemtn.
As God is my witness; when Obama-Care leaves me for dead I swear I will take as many of these bastards with me as I can! I mean, what the hell are they going to do about it kill me?
That’s because it is.
Obama/Dems are masters at double speak, remember it all depends on what the definition of “is” is.
Nothing wrong with folks developing a strategy to 'ease the transition'...VOLUNTARILY, on their own hook. EVERYTHING is wrong when goobermint gets involved with 'developing' such 'strategies'.
But I intend to do all in my power to never let it get that far.
Defeat it now...spread the word to all you know. Put the fear of God and the voters into these reps now so they fear their own constituents more than they fear Pelosi or Obama and it goes down.
Or, failing that, neuter the quislings in 2010 and turn it back thereafter, and particularly after we run the ringer out of the Whitehouse in 2012.
The death panel will have a benign title, something like "Advanced Care Planning Healthcare Coalition." You have to realize, bills are written to deliberately obscure as much as they delineate and define. That's how they get people to go along with the music without reading the words.
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