Your Death, Your Choice

I believe the one Agency that is most often set up as an example of what the proposed public healthcare would be like is the Veterans Administration. This agency is charged with caring for the 24 million veterans in this country. One of their publications is a booklet entitled Your Life, Your Choice.Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.

Here is one of the pages from the booklet, a questionare entitled “What makes your life worth living”.
The kickers are the first two questions at the bottom. They are:

If you checked “not worth living,” does this mean that you would rather die than be kept alive?
If you checked “can’t answer now,” what information or people do you need to help you decide? This is a publication that is ‘under review’ but currently available to our veterans. This should help everyone understand the bureaucratic, governmental approach to healthcare that is already in effect. As you read this form and it’s questions do you feel hope ? I personally sense an attitude of despair.

Update: Over 1200 Veterans wrongly told by the Veterans Administration they have a fatal disease (ALS). And you might think this was just a lab or doctor using wrong addresses. No, it was supposed to be just a standard letter about a change in benefits.

And this is the same government that wants to be your healthcare provider.


  1. It seems like most of this book is just a manual on how to write things like a Living Will, how to specify a proper Power of Attorney, what should happen if you encounter this or that situation. It mentions things in there like the different definitions of “vegetable” and “pulling the plug”. More situations mentioned are “What would happen if I developed severe dementia?” or “What would I do if I were in a coma?”

    It seems creepy, but it’s true. Lots of people don’t plan for certain situations where they can’t speak for themselves in advance. This book seems to just inform the public on planning for your death, so your wishes can be fulfilled.

  2. Randy in Richmond says:

    Did you notice how many religous people or organizations were consulted or helped author this booklet? Did you notice how many times the question or statement ‘I would rather die is interwoven throughout? Did you notice the negative approach to most of the treatments mentioned? How many times was God or a god mentioned about a time in our lives when this is a major issue? This booklet is not about living but has an obsession with death. That people are a burden and perhaps dying is best for all. The questions and comments actually steer people toward dying.
    I have a friend who receives dialysis and has lived avidly this way for 8 years. This booklet implies that can’t happen. How do you think Christopher Reeves would answer the question, ” I can no longer walk but ‘get around’ in a wheelchair”. We recently had a Lieutenant Governor serve four years in a wheelchair. Didn’t Franklin Roosvelt have some accomplishments in a wheelchair? None of the answers are encouraging or positive. “Get around” in a wheelchair? In our nationally known Richmond Marathon here each year there is a category for wheelchairs only. They race for 26 miles!
    This booklet strongly implies you are a burden if you use a wheelchair or receive some of the treatments mentioned. Please point out anything encouraging, other than dying, in the booklet.

    Sorry, we see the same words through very different eyes.

  3. Context counts. One of the subtitles is Planning for Future Medical Decisions. In that context, this is a pretty good document.

    Some of the wording could be better, but obsessed with death? No. There were several references to life as sacred, religious guidance, and even hoping for a miracle. Honoring our elders under end-of-life circumstances is difficult, and just about impossible if they haven’t had this sort of conversation with us in advance.

  4. There were three uses of the word “sacred.” Here they are:

    Your strongly-held beliefs can guide these choices because they help others understand what you value about life. But be sure to explain your beliefs because people often use the same words to mean very different things. Consider the cases of Mrs. Santini and Mrs. Johnson, both deeply religious women.

    “I want to be kept alive as long as possible,” Maria Santini has said on many occasions. “Life is sacred and has meaning, no matter what its quality.”

    “When my time comes, keep me comfortable.” Irene Johnson also believes life is sacred. However, she has often said, “I’ve lived a long and full life. I don’t want anything done just to keep me alive.”

    Because Mrs. Santini and Mrs. Johnson both believe that life is sacred, many people would assume that their views on being kept alive would been the same. But, as you’ve seen, it’s not that simple.

    You can always use that document with your elders and let us know how it goes.

  5. Randy in Richmond says:

    If you had not seen this document before I’m glad I’m the one to shine a light on it for you. I hope you utilize it to the fullest in your life as you follow the advice of a known supporter and advocate of doctor assisted suicide. You may want to download it now as I predict, as with most things Obama, it has a limited shelf-life.

  6. The Lorax says:

    You are son wrong on this. The public option would provide health insurance, not care.

  7. Hey Lorax. Nice job sucking out one point and pretending the others don’t exist.

    This type of issue was written into the 1,000 page + bill the House batted around. Trying to narrow the issue to “public option” is ridiculous. Right on message, but ridiculous.

  8. The Lorax says:

    Not really. Since the government isn’t providing care they can’t force you to make decisions any more than insurance providers would, not that they would want to.

    You said: “And this is the same government that wants to be your healthcare provider.”

    So, yes, you are wrong. The point of the entirety of the bill (all 1,000+ pages, most of which I have read or skimmed) is not to provide care.

    “This type of issue was written into the 1,000 page + bill the House batted around.”

    And had you read the exact wording, it was written in as an amendment to present law that would change definitions to allow the insurance to pay for counseling. But no one reads the bills, anymore, right?

  9. I did think the subject of discussion was the document described in the post, which is not so very different from documents about advance directive planning published by the church, minus the theological discussions. If you search for, say, catholic advance directive, you will find any number of booklets that advise us to steer between the extremes of euthenasia and ‘over-zealous’ medical treatment, including discusions of weighing the benefit/burden to the patient and advising parishoners to think through their preferences ahead of time.

    But of course, the topic of the post was not really the booklet. Silly of me.

  10. Randy in Richmond says:

    Help me out. I just reread my post and also my entry # 2. What is contained in these 49 lines that is not about the booklet with the exception of the few lines on the erroneously mailed letters? Please be more specific as to what the topic really is.

  11. I read it as the document was an example of the type of legislation proposed by the House. A precursor. Randy uses the word “example.”

  12. Randy, what in your comment #5 had anything to do with what I wrote? How did we get from a conversation about ideas to the rather personal “hope” that I follow the advice of one who advocates suicide?

    You mention ideas, but your arguments tend to break down to quasi-Manichean nonsense: total good, total bad. That appears to be your topic ad nauseum. If anyone contradicts you, you divert with superfluous nit picking: 49 lines, .00001 percent who can understand Stroup’s reference, etc., as if being correct on the number of lines puts you squarely in the ‘totally correct’ column.

  13. Randy in Richmond says:

    What have I said at least three times lately–change the subject and attack the messenger. Actually Kathryn, you make my point. Comment # 5 had everything to do with your comment. You said it was a ‘pretty good document’ and further elaborated how it referred to ‘religion, hoping for a miracle and life is sacred’. I am proud to be the one to bring it to you since you support and defend it. And as usual you make no attempt to answer my question in # 10 because you can’t.
    And you’re right that I’m no fence straddling moderate who sways in the wind with whatever populists idea is being floated that day. And contrary to you I will answer a question when asked even if the answer is not popular. My life is lived on values and not on the flavor of the month. And no, I don’t always measure up but I know where I want to be.
    How sad that you choose to live in the gray area of life. I may not agree with Lorax but I sure know what he stands for.
    He’s blue, I’m red. I believe he has joy in his life and know I do.
    Nit picking, yea I do that sometimes. After six years of having that done to my President on every level leads me to enjoy giving it back now and then. And just because you say or believe something doesn’t make it so.

    You never got the point of this post. I was showing what kind of government programs and philosphy we can expect from the proposed healthcare legislation because this booklet already exists. And further, the type of people our government will be calling on to regulate our healthcare. And you calling me a diverter–well there’s that pot and kettle thing.

  14. Oh, I got that point: bad man will cause bad health care system, as evidenced by bad death-obsessesed bureaucratic pamphlet.

    I disagreed with your evidence, (it is not unique) and your interpretation of the evidence (it is not urging death and not without reference to values.)

    Then your argument became, it was written by the bad man. Your reasoning is circuitous and colored by your assumptions.

  15. Randy in Richmond says:

    Your ” then your argument became” statement about the booklet’s author makes no sense as I bring him up in the very beginning of my post.

    Please give me an example of anyone’s reasoning that is not colored by their assumptions.

  16. Yep, you did, and you looped right back to it in #5. The evidence used to support your assertion was challenged, so you supported your evidence by citing the assertion.

    Touche on your last sentence.

  17. Randy in Richmond says:

    Actually Kathryn, I have no idea what you are talking about but I suspect you feel better for it, so good for you. I’m off to play golf.