"Affordable Health Choices Act" and the End of Life

It's often been observed that one of the challenges facing our (and other developed countries') health-care systems is the increasing percentage of health-care spending that goes to those who are very near death.  It has also been observed that one of the reasons to be alarmed by the movement -- misleadingly cast in terms of "dignity" -- for doctor-assisted suicide is the likelihood that the legalization of assisting-suicide will be followed by its normalization and, perhaps, its prioritization.  That is, once we say it is alright to help Grandma kill herself, we might well find ourselves saying that she *ought* to let us help her kill herself.

I was thinking about these two observations as I read this piece, from Forbes, about the end-of-life-related provisions that have been (fairly) quietly inserted into the Bill That No One Dares Read In Its Entirety:

In a post entitled "The Democratic Culture of Death is Absolutely Terrifying." one blogger wrote "First they came for our light bulbs, then they came for our SUVs. Now, they are coming for our senior citizens," Other commentators have made a connection between the bill and the Terry Schiavo episode, in which a woman on life support in Florida starved to death after a feeding tube was removed when her husband prevailed in a prolonged legal battle.

In fact, the bill says nothing about death with dignity or any other code words for euthanasia. It also does not make these counseling sessions in any way mandatory--it just says that Medicare will start reimbursing for them.

Still, some activist groups that are not necessarily opposed to ObamaCare are concerned about the end-of-life proposals in the bill. Marilyn Golden, of the Disability Rights Education and Defense Fund in Berkeley, Calif., has been active in opposing physician-assisted suicide at the state level. Many disabled people worry legalizing suicide would lead to euthanasia.

Golden points out that many doctors, when counseling patients, push for do-not-resuscitate orders or have them sign boilerplate documents that can lead to the premature denial of lifesaving medical care. "I don't want to say we're opposed to the language in the bill," she says. "But there are legitimate concerns about how advanced directives are administered."

"There is reason to be concerned," says Diane Coleman, of Not Dead Yet, a group in Rochester, N.Y., that opposes physician-assisted suicide and what it calls medical killing. "The disability community," she says, "often experiences pressure to sign treatment-withholding orders."