1. Headline
  1. Headline
By
msnbc.com contributor
updated 12/29/2010 2:09:45 PM ET 2010-12-29T19:09:45
Commentary

Watch out! The "death panels" are back. They are going to be used by Obama and his horde of federal health reformers to make sure that if you are old, very sick and go into a hospital, you will never return.

So goes the line of utter malarkey put forward with a straight face and Twitter finger last year by Sarah Palin, who notoriously and ridiculously coined the term "death panels" to vilify efforts to legislate paying doctors to talk with Medicare patients about their health care options if they become terminally ill. Her critique worked. The provision to pay doctors for the time involved to talk about end-of-life care for older Americans was dropped from the health reform bill.

But it has come back, this time in the form of regulations to be issued on Jan. 1 by the Department of Health and Human Services. If an elderly person is offered a chance to do advance care planning by their doctor and wants to do so, then Medicare will pay the doctor for the time involved.

  1. Don't miss these Health stories
    1. More women opting for preventive mastectomy - but should they be?
      Splash News

      Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 perce...

    2. Larry Page's damaged vocal cords: Treatment comes with trade-offs
    3. Report questioning salt guidelines riles heart experts
    4. CDC: 2012 was deadliest year for West Nile in US
    5. What stresses moms most? Themselves, survey says

Some conservatives and right-to-lifers see rationing afoot. They think encouraging these discussions is simply a way to get old folks to save the federal government money by slyly tricking them into saying that they don’t want a lot of medical care if they are terminally ill. Not only are they wrong, they are dead wrong.

Talking with your doctor about what you want to happen and who you want to make decisions for you if you become terminally ill is something every American, young and old, should do.

If you want aggressive care to the very end then you need to say so. If you don’t want to be kept alive with technology should you have a deadly cancer that does not respond to treatment then you need to let your doctor and your family know.

Story: Obama enacts end-of-life plan that drew 'death panel' claims
  1. More from TODAY.com
    1. TODAY's Takeaway: Savannah overshares; Billy Crystal brings '700 Sundays' to TV

      Witnesses describe hearing the Mount Everest avalanche, Savannah already overshares and Billy Crystal brings "700 Sundays"...

    2. 'You helped me': After 23 years, Desert Storm veteran thanks pen pals
    3. Alan Thicke: 'I have a better body' than Homer Simpson'
    4. Kids scared of the Easter Bunny? Well, look at him!
    5. 'We are not equipped for this': Tamron, Willie face off against animals

Few people are comfortable with the topic of death. Some, like Sarah Palin, seem to think that if they pull the covers over their head the Grim Reaper will go away. Not so. Each of us will face end-of-life decisions if not for ourselves then for our family or friends.

Anything, including Medicare money, that can encourage doctors, many of whom do not want to have this conversation with their reluctant patients, to do so is a sound, moral and prudent policy.

No one is telling you what you must say. No regulation says that you cannot insist that everything possible be done. No bureaucrat is whispering in your doctor’s ear to spin the conversation toward insuring your premature demise.

You can change your mind at any time about your views and wishes including during your time in a hospital, nursing home or hospice. Nothing is locked in stone by having this initial conversation about what you want and who you want to make decisions for you if you cannot do so.

If Terri Schiavo taught us anything, it was that you need to specify to your doctor and family who should make decisions for you about your medical care if you are unable to communicate.

If the political conversation over death panels and advance care planning has taught us anything, it is that Washington, D.C., is not the place to talk about end-of-life care — your doctor’s office is.

Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania.

© 2013 msnbc.com.  Reprints

Discuss:

Discussion comments

,

More on TODAY.com

TODAY's Takeaway
  1. TODAY

    Savannah overshares; Billy Crystal brings ‘700 Sundays’ to TV

    4/18/2014 8:29:08 PM +00:00 2014-04-18T20:29:08
  1. Doomed South Korean ferry’s captain taken into custody

    The captain of the sunken ferry in South Korea was taken into custody Friday and is facing five charges, including criminal negligence.

    4/18/2014 8:35:55 PM +00:00 2014-04-18T20:35:55
  2. Did South Korea ferry’s sharp turn cause it to sink?
  3. Teen ferry survivors comforted in devastated town
  1. Courtesy of Shawn Stock

    'You helped me': After 23 years, Desert Storm veteran thanks pen pals

    4/18/2014 8:51:52 PM +00:00 2014-04-18T20:51:52
  1. Courtesy of Kristen Hazelwood Jo

    Kids scared of the Easter Bunny? Well, look at him!

    4/18/2014 7:18:23 PM +00:00 2014-04-18T19:18:23
  1. This weekend on TODAY: Apps to keep teens from texting and driving

    Janice Lieberman takes a look at three new apps that are designed to keep your teens safe behind the wheel. Also, Ed Weeks from “The Mindy Project," the right way to cook a perfect Easter ham and more.

    4/18/2014 4:41:45 PM +00:00 2014-04-18T16:41:45