End Of Life Counseling???!!!??

Spalladino, You have always(in my brief time here on MyLot)chosen to believe the very best about BHO and all of his policies. If this were JUST the rantings of one or two websites it might not carry very much weight but it is all over the net and believe me, I have read it an come to the same conclusions. The "end-of-life" counselings are mandatory and are not the kind a family and loved one would normally conduct with a trusted physician. If this is what was intended then why EVERY five years and why would it become even more frequent if and when the loved one needed the special care of a 24 hour facility like a nursing home? There is no logical answer but that what is really intended and that is to push senior citizens to just go ahead and die and take this awful burden frome your family and most of all insurance system. This is only one of the idiotic parts of this plan. I have to ask you, Spalladino, if it is going to be such a great thing for the government to completely take control of our insurance(and don't be fooled, this is exactly where it is headed)why is it that congress and the president are not touting the great accomplishments of medicare and medicaid and government run healthcare of other countries? Short answer? Because they are all nightmares! Since November of last year (and yes, Bush has his part in this)our government has been systematically taking control of every facet of our economy from the financial district to the housing industry and the automobile industry and now healthcare. Can you say socialism?

Rodney I don't support all of Obama's policies...if I did I wouldn't have driven over an hour to attend one of the first round of TEA parties here in Florida. I do, however, use my own judgement to evaluate things. No, I don't believe that the government should be involved in this country's banking or automobile industry but I do understand that something drastic had to be done in order to prevent the total collapse of our economy. You're mistaken about this "counseling" not being conducted with family and the patient's physician as you will see in the actual bill I've provided below. The reason for the 5 year review is because an elderly person's health issues change and many times things like advance directives are overlooked by the patients and their families. If these health issues make hospitalization or admission to a long term care facility necessary, it's only logical to review the record more frequently. Nowhere in the bill is the decision making taken away from the patient or the person acting as the medical proxy. Even in the section that covers the doctor's orders, it indicates that the medical order "effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;" Read the information below, Rodney. You will see the words "life sustaining" again and again. Nowhere in the bill does it even suggest that a patient should be encouraged to just go ahead and die. From the actual bill: [b]Subject to paragraphs (3) and (4), the term `advance care planning consultation' means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following: `(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to. `(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses. `(C) An explanation by the practitioner of the role and responsibilities of a health care proxy. `(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965). `(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title. `(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include-- `(I) the reasons why the development of such an order is beneficial to the individual and the individual's family and the reasons why such an order should be updated periodically as the health of the individual changes; `(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and `(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a health care proxy). `(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State-- `(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and `(II) that has in effect a program for orders for life sustaining treatment described in clause (iii). `(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that-- `(I) ensures such orders are standardized and uniquely identifiable throughout the State; `(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional's authority under State law) may sign orders for life sustaining treatment; `(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and `(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association. `(2) A practitioner described in this paragraph is-- `(A) a physician (as defined in subsection (r)(1)); and `(B) a nurse practitioner or physician's assistant who has the authority under State law to sign orders for life sustaining treatments. `(3)(A) An initial preventive physical examination under subsection (WW), including any related discussion during such examination, shall not be considered an advance care planning consultation for purposes of applying the 5-year limitation under paragraph (1). `(B) An advance care planning consultation with respect to an individual may be conducted more frequently than provided under paragraph (1) if there is a significant change in the health condition of the individual, including diagnosis of a chronic, progressive, life-limiting disease, a life-threatening or terminal diagnosis or life-threatening injury, or upon admission to a skilled nursing facility, a long-term care facility (as defined by the Secretary), or a hospice program. `(4) A consultation under this subsection may include the formulation of an order regarding life sustaining treatment or a similar order. `(5)(A) For purposes of this section, the term `order regarding life sustaining treatment' means, with respect to an individual, an actionable medical order relating to the treatment of that individual that-- `(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional's authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care; `(ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual; `(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and `(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual. `(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items-- `(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems; `(ii) the individual's desire regarding transfer to a hospital or remaining at the current care setting; `(iii) the use of antibiotics; and `(iv) the use of artificially administered nutrition and hydration.'. ...(b) Expansion of Physician Quality Reporting Initiative for End of Life Care- omitted as not relevent to this discussion or patient care. (c) Inclusion of Information in Medicare & You Handbook- (1) MEDICARE & YOU HANDBOOK- (A) IN GENERAL- Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall update the online version of the Medicare & You Handbook to include the following: (i) An explanation of advance care planning and advance directives, including-- (I) living wills; (II) durable power of attorney; (III) orders of life-sustaining treatment; and (IV) health care proxies. (ii) A description of Federal and State resources available to assist individuals and their families with advance care planning and advance directives, including-- (I) available State legal service organizations to assist individuals with advance care planning, including those organizations that receive funding pursuant to the Older Americans Act of 1965 (42 U.S.C. 93001 et seq.); (II) website links or addresses for State-specific advance directive forms; and (III) any additional information, as determined by the Secretary. (B) UPDATE OF PAPER AND SUBSEQUENT VERSIONS- The Secretary shall include the information described in subparagraph (A) in all paper and electronic versions of the Medicare & You Handbook that are published on or after the date that is 1 year after the date of the enactment of this Act. [/b]

I forgot to mention that I added something extra at the end. The information about advance directives, medical proxies and available resources for information about this issues will be included in the new Medicare Handbook. Also, here's a link to the Bill. http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200 Look down the page for Division B: Medicare and Medicaid Improvements.

I agree, it IS personal. But to carry this even further, what Obama and his patsys in congress are proposing is to send counselors who might suggest ways of not extending but concluding one's life. Again a very personal choice or decision. Some questions; how do you "counsel" someone with alzheimers? Does this "counseling" mean that people in latter stages of Lou Gerhigs will be allowed to end their life? I've always been taught that life is sacred and where there is life there is hope. Liberals don't want anyone telling them what choice to make when it comes to abortion but they want to tell my parents how to cut their life short. That dog won't hunt!

What I believe is going to happen with this legislation(if its passed) will be counselors trained to strongly suggest to the elderly that choosing to die rather that treatment would be the right thing to do. In essence, they would be touting euthanasia. I don't have a problem with people choosing to die, if it is their choice, not some government paid "counselor".

Rodney, instead of believing the rantings of wnd.com, you need to read the bill. There is nothing in it that even remotely suggests what you have envisioned. The counseling includes life sustaining arrangements...how much medical support a patient wants is also a very personal choice and one that needs to be in writing so that the patient's wishes are abided by. Read my response below for more specifics on the bill since my information comes from it and not a questionable website.

Great article Destiny! But of course you know the Spectator is just another ranting rag!(turns off sarcasm)

Let me know which of these you find "reliable"! http://www.lifenews.com/bio2896.html http://www.americanthinker.com/blog/2009/07/government_counselors_on_end_o.html http://www.politifact.com/truth-o-meter/statements/2009/jul/23/betsy-mccaughey/mccaughey-claims-end-life-counseling-will-be-requi/ http://soitgoesinshreveport.blogspot.com/2009/07/obamacare-to-dictate-end-of-life.html http://worshippingchristian.org/blog/?p=8451 http://www.familysecuritymatters.org/publications/id.3790/pub_detail.asp And you might want to watch this video all the way through. http://www.foxnews.com/video2/video08.html?maven_referralObject=7117041&maven_referralPlaylistId=&sRevUrl=http://www.foxnews.com/story/0,2933,534125,00.html

you've done your research, well done... had a look at the fox one (once you get past the spin fox usually is ok). well it is a matter of interpretation so won't take back what i said. you might not agree with it but the intention does not at all seem to be to try and get rid of old people. whether or not it is the right way to go about things is debatable.

I read the bill...days ago...and didn't find anything vague about it at all. This type of counseling is NOT unusual. Doctors have been encouraging patients to put their wishes in writing and to designate someone to act on their behalf for years. Doctors have been explaining the progression of an illness or disease to their patients as well as what their options will be down the road for years. This is not done by "counselors". These are conversations that every doctor should already be having with patients who are elderly or who have progressive illnesses.