Monday, August 24, 2009

Death Book Denied: End of Life Questions for Vets

By Maggie at Maggie's Notebook

Today on the news, the "Veteran Death Book" dominates. The Wall Street Journal put the information out there, with an article by Jim Towey. In the video below, you will hear a full discussion of the Death Book between Towey and Chris Wallace, and then Veterans Administration Secretary Tammy Duckworth and Wallace.

Tammy Duckworth - Veteran End of Life Questions

The controversy revolves around the book Your Life Your Choices. At one point it asks the question "What makes your life worth living?" You'll see the questions below but if you fit a certain category, you are referred to the Hemlock Society, with it's newly renamed moniker, Compassion and Choices. It is the only organization Veterans are referred to.

Along with the excellent discussion below, and Towey's WSJ article, Kimberly Morin of the Boston Conservative Independent Examiner has some of the best commentary I've seen today. Cutting to the chase before you watch the video, Morin downloaded 'Your Life, Your Choices' (the Veteran's Death Book) and here is a portion from from her article:
...there is a check list in the middle of the document that specifically asks questions about "What makes your life worth living?”. It is a checklist that doesn’t just include needing a feeding tube or being on permanent life support, the questions are absolutely, in my opinion, insane. These questions are being asked to all Veterans receiving treatment, including 20 year olds who have been severely wounded in Iraq or Afghanistan. I have listed all of the questions below so you can see for yourself:

a. I can no longer walk but get around in a wheelchair.
b. I can no longer get outside—I spend all day at home.
c. I can no longer contribute to my family's well being.
d. I am in severe pain most of the time.
e. I have severe discomfort most of the time (such as nausea, diarrhea, or shortness of breath).
f. I rely on a feeding tube to keep me alive.
g. I rely on a kidney dialysis machine to keep me alive.
h. I rely on a breathing machine to keep me alive.
i. I need someone to help take care of me all of time.
j. I can no longer control my bladder.
k. I can no longer control my bowels.
l. I live in a nursing home.
m. I can no longer think clearly-I am confused all the time.
n. I can no longer recognize family/friends
o. I can no longer talk and be understood by others.
p. My situation causes severe emotional burden for my family (such as feeling worried or stressed all the time).
q. I am a severe financial burden on my family.
r. I cannot seem to “shake the blues.”

These questions are followed by the questions below:

“If you checked "worth living, but just barely" for more than one factor, would a combination of these factors make your life "not worth living?" If so, which factors?

If you checked "not worth living," does this mean that you would rather die than be kept alive?

If you checked "can't answer now," what information or people do you need to help you decide?”

What the hell kind of questions are these to be asking Veterans who have just risked their lives to keep America safe from terrorists? What kind of person would ask a 20 year old quadriplegic if they would rather die than be in a wheelchair or a burden to his/her family or if they have the blues? Of course they would have the blues in this case and of course no one wants to be in a wheelchair and of course no one wants to be a burden on their family but to suggest to a Veteran that these answers possibly mean they would ‘rather die than be kept alive’ is atrocious, outrageous, disgusting, immoral, unethical and one of the most un-American things I have ever read in my entire life.

Tammy Duckworth, Assistant Secretary of Veterans Affairs appears in the second half of the video. Duckworth, a severly injured Iraq war aviator, tells Wallace the book is not available to veterans. Wallace points out that it has been available until this week. She denies it. Wallace has a screen grab to prove it. Wallace reads the following to Duckworth as content currently on the VA website:
In the VHA directive of July 2nd, 2009, it says the following on page 8, "Primary care practitioners are responsible for giving patients pertinent educational materials, e.g. refer patients to the 'Your Life, Your Choices' module." I mean, it's just there in black and white on the VHA directive of July 2nd.
Secretary Duckworth continues to deny it. Transcript of Wallace-Towey-Duckworth discussion here or in the video below:

Veteran End of Life Questions

Throwing Tammy Duckworth Under the Bus


  1. Wallace showed 'edited' portions of the directive on the screen .. he left out the parts that didn't support his argument.

  2. Oh, I just saw that the owner (you) have to approve my comment, so I guess it won't be shown?

  3. Archivist: we only reject comments that are rude and off-top.

    For this discussion, please tell me what, in the "edited" portion, changes the fact that the questions are there with a lead to the now renamed Hemlock Society.