But now try to imagine tens of thousands of these doctors with the legislative and governmental authority to command or deny care

I am very sorry for your loss, but this is not the “fault” of the hospice system, it is an isolated failing with this particular patient. I apologize in advance for the seemingly insensitive tone of what is to follow, but you are using the case in question for the purpose of making sensational accusations, which simply have no foundation in reality.

A hospice is not a one-way ticket to death. A hospice is a place where patients are cared for and made comfortable, once they have decided to forgo further treatment. Patients may enter a hospice, change their minds and come out of the hospice, at any time of their choosing and their family’s choosing.

The first thing that I can say about this case is what in the world was the patient doing in a hospice if her tumors were regressing on treatment? No one has the power to order a patient into a hospice; not now and not in the future. Where in the world do you get the stuff about doctors with the “governmental authority to command or deny care?” That’s never going to happen. It’s scaremongering of the worst kind. What any insurance plan can do is to refuse to pay for treatment on the grounds that it’s not medically necessary, according to the provisions of the insurance, whether private or public. But this sort of thing (denying payment for treament) is much more common with private sector insurance than with Medicare, and it’s a far easier task to challenge Medicare payment denials than private insurance payment denials. And the patient would always have the option of paying for care himself/herself, either out of pocket or with supplemental catastrophic insurance.

Getting back to the patient in question: Why was she in a hospice, if she was really responding to treatment? Who made this decision? You don’t put a patient in a hospice to treat nausea, when they are responding to treatment, for goodness sake! And you certainly don’t treat nausea with Fentanyl and morphine! These drugs make nausea worse! (I suspect that the patient was receiving these drugs for pain relief — these drugs are powerful pain relievers and are NOT anti-nausea medications — which makes me also believe that she wasn’t responding to treatment, which would be consistent with the decision to enter a hospice).

Another observation: One doesn’t need to be in a hospice to have one’s death hastened by Fentanyl and morphine.

- Larry Weisenthal/Huntington Beach, CA

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My wife Maril;yn Morrissey died on August 18 2009 of starvation and overdosing of morphine by the orders of a hospice doctor.She had been suffering from pancreaic cnacer, but was on an experimental vaccine Telomerase peptide now in phase III clinical trials in the UK. The vaccine was working. Her tumors were regressing and her pancreas had shrunk. Unfortunately, she had continuos nausea which her doctors treated with Fentanyl a very powerful synthetic opiod, and with morphine sulfate. unknow to her family these sedatives depressed her nervous system , caused her to sleep for long periods ,slowed down paracelsus in her intestines and reduced her appetite, among other effects. Her hospice doctor announced that ehr organs were shutting down and estimated that she had 24 hours to live at most. After several days in dawned on us, her family, that her organs were fine, but by that time it was too late.She no longer could swallow or eat enough to survive.The lack of food had made it impossible to save her, even though she was about to become one of the few people in history to recover from stage 4 pancreatic cancer.Had we been a little smarter we would have told the Hospice people to get out of our sight and she would be here today.We werent smart enough to fight off the attempts to sedate her to death,a tragedy from which we will never recover.
But now try to imagine tens of thousands of these doctors with the legislative and governmental authority to command or deny care.Are they smart enough to know who can be saved and who cannot? Not on your life or on the lives of your loved ones. As one who has suffered from a very limited dose of a death panel, do not let this happen.

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Curt, Newsweek’s Thomas is being more than misleading when he stated patients wait longer for primary care appointments here than in Britain and Canada under their NHS systems. He is referring to the very real complaints with our Medicaid Managed Care plans in state after state, which are as bad as the Brits. Medicaid is owned by the Federal goverment, run by the States and politically contracted out to “approved” providers; it is not the American system, but is the sociallized system. Newsweek BS’s when it makes believe Medicaid problems are not sociallized medicine at their worst.

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Conservatives have said for a long time that we need tort reform, as the author agrees. We also agree that many times there are way too many tests run, a byproduct of the malpractice suits against doctors. Fix one and the other will fix itself.

Curt, We’ve had the type of tort reform the conservatives advocate here in California for 30 years: Drastic limits on pain and suffering (only $250K). Texas passed a similar law a few years back. There isn’t one iota of evidence that this has in any way reduced “defensive medicine” tests or lowered costs of health care to patients or insurers. Any savings in malpractice premiums has just been pocketed. You can’t lower pain and suffering lower than $250K. How would you feel if you had one bad kidney and one good one and the surgeon removed the good one, condemning you to a foreshortened life hooked up to kidney machines for 5 hours 3 or 4 times a week, while you wait for a transplant, which will require you to take powerful immunosuppressant drugs for the remainder of your (foreshortened) life. You think you don’t deserve a measly $250K for your troubles?

With regard to end of life counseling (“death panels”), no one understands that the most common situation where this comes up is in patients with terminal cancer, who have already failed several forms of the “best” chemotherapy. Oncologists can easily just keep writing orders for infusion chemotherapy, which only makes the patients feel worse, but which makes the oncologists money, or they can spend an hour, having a serious discussion with patients about the realistic likelihood of benefit and the (delicate and often psychologically painful) alternatives. Thanks to Palin, the oncologists will be more likely to just keep pushing the drugs, taking the money, and running.

It’s always easier and more profitable to treat than to counsel. In everything from common viral upper respiratory infections (where antibiotics don’t do anything to help) to cancer. Palin wants to keep it that way, and it looks as if she’s succeeded. I think it’s a tragedy.

- Larry Weisenthal/Huntington Beach, CA

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They wouldn’t let her?

She can leave the facility AMA and then Evan can starve her if that’s what she really wants. That would free up a bed for someone who is in need for one.

As always, Thomas is full of crap.

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[...] is saying that Sarah Palin lied about death panels, but, that we should have them? Dude! Flopping Aces has the [...]

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Would vegans eat Soylent Green? Just wondering.

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