We've all seen the Republicans make up facts and arguments merely because they are momentarily convenient for whatever issue they're focused on at that moment. Links between bin Laden and Saddam. A floating train to Disneyland. An order that Marines have to read people they capture in battle their Miranda rights. The list goes on and on. Originally, I thought the characterization of the Living Will provisions in the various health care bills was just that - an invented specter pushed purely as a tactic to win a debate, with no real underlying principle behind it.
I was wrong.
Looking back at the records of the people blasting the End-of-LIfe-Counseling provisions makes it clear that, far from being a throw-away line in the health care debate, this gambit actually represents an effort to impose the same extreme version of a pro-life ideology onto the health care system that was last seen during the controversy surrounding Terri Schiavo. Put simply, extremist pro-lifers are opposed to patients having control over their End-of-Life-care decisions, because they are unalterably opposed to allowing people to choose a course of treatment that doesn't include the most aggressive interventions to keep the heat beating as long as possible. They call this "erring on the side of life."
Here is National Review's Kathryn Jean Lopez, with a column titled Don't Give Up: Tis Better to Err on the Side of Life. She tells us,
Terri was the brain-damaged woman in Florida, stuck in a hospice bed, who couldn't speak for herself and ultimately had hordes ready to.
Here is President Bush, telling us,
"But in extraordinary circumstances like this, it is wise to always err on the side of life."
Here is James Lileks telling us, after providing a picture of a Star Trek character to show how serious he is, tells us,
In short: err on the side of life is not a bad motto to keep in mind.
So, why do these people keep talking about "erring?" It's not like Wingnutus Americanus to admit to this kind of uncertainty, so why raise the matter of doubt? Because, as you may very well remember, doubt was the central argument for disobeying Terri's wishes, as described to us by her husband, Michael. Mrs. Schiavo, you see, never had a living will. She'd never discussed her wishes regarding End-of-Life care and extraordinary life-saving measures with her doctor. As a result, the pro-lifers could claim that her husband was a big, fat liar, and we couldn't really know what her wishes were. And, they asked while stroking their chins, in a case with so much doubt about what the patient would want, shouldn't we "err on the side of life?"
It is an argument that relies upon the existence of doubt regarding the patient's wishes. Take away that doubt, make the patient's wishes clear, and we don't get to "err" at all. So what do we see now? Republicans fighting against a provision that would remove that doubt, and ensure that the patient's wishes are known. They are working to ensure the existence of the very doubt that they rely upon to impose their vision of proper end-of-life medical care.
Let there be no doubt that their preference for this type of treatment is a based on pro-life ideology, rather than patient autonomy. Look at their determined campaignagainst Oregon's Death With Dignity law, in which the Ashcroft/Bush Justice Department tried to deny patient autonomy in the cause of "Life." Or, look at the argument made in the Lopez column linked to above:
Christopher Reeve, Terri Schiavo and Haleigh Poutre are all very different — different circumstances, different ages, different classes. But they should all make us think about the same question: Shouldn't we always err on the side of life?
Which is to say, because Christopher Reeve and Haleigh Poutre recovered from injuries after some had recommended withholding treatment, it should always be assumed that keeping the heart beating is the proper course of treatment. You can search through that article all you want, and you won't find a single word about Reeve, Poutre, or Schiavo's wishes - because the patients' wishes are not what her argument is about. It is about one course of treatment - the tubes, the machines, the wires - being the right one.
No doubt, some of the people making the Death Panel argument are simply latching onto what they see as a convenient line. Most of them are thinking about rationing medical care, and see the End-of-Life Counseling provision as a slippery slope to rationing. However, when I saw Pat Buchanan, who wrote this,
Did Terri, at 26, really tell the man to whom she swore lifelong fidelity to find a way to kill her if she became handicapped? Is that what she had in mind when they pledged to stand by each other "in sickness and in health, 'til death do us part"?
Was Terri that different from her mom, dad, brother and sister, who fought with all they had to keep her alive so they could take care of her for all the years she had left? Why, one wonders, did this severely handicapped woman fight for two weeks against the dying of the light?
declare that "the Death Panels have been removed" after the Senate Finance Committee removed the End-of-Life-Counseling provision from their bill (not the Medicare Advisory Council, which would seem to be a more logical target for such a charge), it became clear to me that this dispute comes from the same place as the circus surrounding poor Terri Schiavo's death. Republicans are actively working against the right of patients to determine their own End-of-Life care, because they think they know better.
They can't be allowed to get away with it.