Thread between Veterans Affairs’ “death book” and Section 1233: Hemlock Society

your life your choices.jpgOn August 18 the Wall Street Journal published an op ed Jim Towey, president of St. Vincent College, former director of the White House Office of Faith-Based Initiatives and author of Five Wishes, the most widely used living will template in the country.
Towey’s piece has gotten much attention. The piece begins:

If President Obama wants to better understand why America’s discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Dept. of Veterans Affairs. He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care….

Last year, bureaucrats at the VA’s National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, “Your Life, Your Choices.” It was first published in 1997 and later promoted as the VA’s preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated “Your Life, Your Choices.”


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.
“Your Life, Your Choices” presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political “push poll.”…
I was not surprised to learn that the VA panel of experts that sought to update “Your Life, Your Choices” between 2007-2008 did not include any representatives of faith groups or disability rights advocates. And as you might guess, only one organization was listed in the new version as a resource on advance directives: the Hemlock Society (now euphemistically known as “Compassion and Choices”).

Recall Compassion and Choices is the group pushing the infamous Section 1233 of a House version of Obamacare, which mandates doctors initiate end-of-life conversations with older patients.
A click on the link for “Your Life, Your Choices” at the VA website indicates the document is currently under revision. Only the old version is posted.

9 thoughts on “Thread between Veterans Affairs’ “death book” and Section 1233: Hemlock Society”

  1. because they want to get rid of them?
    Sort of how Terri Schindler’s husband said nothing about her wanting to “not want to live this way” until he was awarded that $2 Million in court for the lawsuit against that gynecologist I think it was…….and then all of a sudden he says “she said she didn’t want to live this way if this ever happened”

  2. Looking at the drawing on the booklet ‘Your Life, Your Choices’, it looks as though the parents are presenting little Billy with a bill for their and his health care which of course he’ll have to pay when he gets older…or maybe not.

  3. Even before the Nazis took open charge in Germany, a propaganda barrage was directed against the traditional compassionate nineteenth century attitudes toward the chronically ill, and for the adoption of a utilitarian, Hegelian point of view. Sterilization and euthanasia of persons with chronic mental illnesses was discussed at a meeting of Bavarian psychiatrists in 1931.[1] By 1936 extermination of the physically or socially unfit was so openly accepted that its practice was mentioned incidentally in an article published in an official German medical journal.[2]
    Lay opinion was not neglected in this campaign. Adults were propagandized by motion pictures, one of which, entitled “I Accuse,” deals entirely with euthanasia. This film depicts the life history of a woman suffering from multiple sclerosis; in it her husband, a doctor, finally kills her to the accompaniment of soft piano music rendered by a sympathetic colleague in an adjoining room. Acceptance of this ideology was implanted even in the children. A widely used high-school mathematics text, “Mathematics in the Service of National Political Education,”[3] includes problems stated in distorted terms of the cost of caring for and rehabilitating the chronically sick and crippled, the criminal and the insane.”
    The first direct order for euthanasia was issued by Hitler on September 1, 1939, and an organization was set up to execute the program. Dr. Karl Brandt headed the medical section, and Phillip Bouhler the administrative section. All state institutions were required to report on patients who had been ill five years or more and who were unable to work, by filling out questionnaires giving name, race, marital status, nationality, next of kin, whether regularly visited and by whom, who bore financial responsibility and so forth. The decision regarding which patients should be killed was made entirely on the basis of this brief information by expert consultants, most of whom were professors of psychiatry in the key universities. These consultants never saw the patients themselves. The thoroughness of their scrutiny can be appraised by the work of on expert, who between November 14 and December 1, 1940, evaluated 2109 questionnaires. These questionnaires were collected by a “Realm’s Work Committee of Institutions for Cure and Care.”[4] A parallel organization devoted exclusively to the killing of children was known by the similarly euphemistic name of “Realm’s Committee for Scientific Approach to Severe Illness Due to Heredity and Constitution.” The “Charitable Transport Company for the Sick” transported patients to the killing centers, and the “Charitable Foundation for Institutional Care” was in charge of collecting the cost of the killings from the relatives, without, however, informing them what the charges were for; in the death certificates the cause of death was falsified.
    There is nothing new under the sun and liberals may change their name but they will never change their stripes and the cannot hide the yellow stain running down their legs.
    Liberals are now marketing themselves under the euphemistic term ‘progressive’. To understand this term in context you have associate it with ‘income tax’. When you hear someone identifying themselves as ‘progressive’ think ‘progressive income tax’. A tax system that punishes success and encourages mediocrity. A system that says because you have more you should be required to share with someone who has less.
    ‘Progressives’ want to kill grandma and granddaughter in order to achieve they have determined is the optimum population of humans on planet earth so the ‘progressives’ quality of life will not be threatenend.
    ‘Progressives’ profess to be egalitarian, but their actions reflect aristocracy.
    ‘Progressives’ claim that all persons are equal, but what they really believe is they are more equal than any one who does not agree with them.
    Progressives are elite erudite egocentrics who label anyone who would dain to refute their fantasies as ‘knuckledraggin neanderthols’.
    I think we should arm the ‘progressives’ with government provided or subsidized hand guns and stand back and let nature take it’s course.
    Some progressives will kill themselves out of pure ignorance or hopeless helplessnes.
    Some will kill their fellow progressive out of jealousy or hatred or in the best interests of mother earth.
    Some will be so terrorized and intimidated they will not come down from their ivory towers or leave their liberal plantations for fear of becoming a victim of friendly fire all the while indifferent to or ignorant of the victims of their godless beneficence.
    yor bro ken

  4. Just read the entire book online. Clearly, it is designed to help make end of life decisions easier for our veterans, and to keep from having their wishes debated by others. I found it thorough and educational, as many new recruits would probably find it – or soldiers who had never been in war. There are options in almost every section regarding religious wishes – I.e. “I want a religious representative consulted about every decision regarding my care.” There are sections that ask thought-provoking questions in order to get readers to delve into why they want certain options for themselves, and sections that explain diseases and their treatments. The book then lists pros and cons about these treatments. I guess I don’t get all the hubbub. My only complaint is that it relies on fictitious scenarios in order to explain different medical situations. But the I remembered how a marketing colleague of mine told me that the average reading level of Americans is 8th grade and it sort of made sense. Where’s all the uproar over THAT??!

  5. Beckybo, don’t you notice a big difference between the Health Conditions section and the Treatments section? Each of the four health conditions is introduced by asking a neutral question: What is it? Four of the treatments begin with a negative question: What’s the problem? Isn’t it interesting that hospice and pal care are the only treatments that don’t open with a negative question but instead use the neutral “What is …” question?
    That’s just one of numerous examples of negative bias in the booklet.

  6. i was completely misled when my ex husband was put into hospice at the VA hospital. They said he would have a big private room, with TV and VCR.
    The Dr. had given him about 3 months to live, his lungs were bad. He was perfectly content to have his meals served to him and watch TV. He was not in pain, he just needed oxygen.
    I called all 5 of our children all local except 1 in Vegas and 1 in Texas. This was on a Thurs. They put him in hospice on Fri. Daughter came in from Vegas that night and son in Texas was due in the following Thurs.
    I only saw him awake twice, they gave him morphine and adavan, all bad for his lungs. He Died on Wed. day before our sone was due in from Texas.
    They killed him, just get him out of the system.
    I am not a dumb person when it comes to medications, I had power of attourney, and told them not to give him these medications any more and they did it anyway. We were there everyday, there would be a nice tray of food sitting untouched because he was knocked out….THEY KILLED HIM. before our son could get to see him one last time.
    They are heartless bastards and have no right to play god. They knew all the time what they were going to do and led me to beleive that he would have his meals which he was capable of eating on his own, going to the bathroom on his own, he even asked me to bring him some clothes, because he wanted have regular clothes on when he felt like geing up. Now I know why when I showed up with the clothes they asked me what they were for, I told them and they just looked at me like I was some dumb bimbo, they knew exactly what the plan was.
    I would not have ever agreed to them putting him there if I had known.

  7. I have been quite concerned with the hyperbole and misinformation concerning the HR 3200 bill that is only one of many being proposed to be made law. Doing what I do required me to be better informed of the facts. I did two things most haven’t and those are: 1. I read it. Go to and it has the text of the bill(s) without the commentaries. 2. I spoke in person and in private with our Congressman on August 21, 2009 who confirmed the meaning of the use of “shall” in bills submitted to be made law. He also did not know what a DNR order was!
    The language used in HR3200 mandates (with the word shall) that a Presidentially appointed counselor shall do end-of-life counseling with those who are 65 and sooner if they are chronically ill or have a terminal illness. Discussed would be similar topics as I, as an RN that does such counseling with all patients that are of legal age; wish to do so; and have the mental capacity to understand what it means. That person may include their family and loved ones in their discussion. The meaning of terms like CPR and its implications as well as any and all questions the person and families (if decided by the patient)are answered. The document then is presented to the person’s doctor and it is signed into effect if the doctor feels it is in their best interest to do so. The doctors have been compensated all along, as have all the RN’s. The question then becomes why this procedure is included in this bill? Why is a government that is supposedly not interested in denying individuals their freedom of choice involved in trying to mandate this process into law? An interesting bit of information about that specific section of the proposal is that it was authored by an Oregon Congressman. Oregon is one of two states (Oregon and Washington) that has it as legal for medically assisted suicide to be done. Why does this administration feel it is appropriate for the Veterans Administration to resurrect “Your Life-Your Choices” to be given to the patients and participants in their healthcaree system…also allowing its use in Nursing Home residents? The guidelines to make decisions concerning these delicate matters are discussed by using questionaire type format with a “scoring” algorythm with questions put into “would you want to live if…form. Patients in these institutions are not in a particularly loving, caring environment, surrounded by others that have their best interests at the forefront. I could go on and on; but I think you understand by now that I believe that this effort by this Administration needs to take a large dose of Hemlock and die. Jerry P. Hawker BSN, RN

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