2011/05/06

Death panel myth

Death panel

"Death panel" is a political term coined by former Governor of Alaska Sarah Palin in August 2009 on her Facebook page. She said that the health care legislation then being debated in the House of Representatives would require Americans such as her parents or her child with Down syndrome, "to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care." The trigger for the "death panel" claim was a provision in the House of Representatives Bill 3200 (2009) that would have reimbursed physicians for counseling Medicare patients about living wills, advance directives and other end-of-life issues.

The uproar that the phrase produced was described by TIME Magazine and The Washington Post as almost taking down President Obama's health care reform. PolitiFact.com called "death panels" the "Lie of the Year". FactCheck.org referred to it as one of their "whoppers" of 2009, and the American Dialect Society said that "death panel" was their "most outrageous" word for 2009. In November 2009, Palin said the term should not be taken literally, but rather was meant to get people thinking about the issue as when Ronald Reagan called the Soviet Union the "evil empire".

Origins

Prelude

Betsy McCaughey, a former lieutenant governor of New York who campaigned against the Clinton health care plan of 1993, began concerns over 'death panels' during the July 16 Fred Thompson Show. During the radio interview McCaughey addressed H.R. 3200 Section 1233, charging that the proposed legislation was a "a vicious assault on elderly people" which mandated counseling sessions for Medicare patients every five years to "tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go in to hospice care" in order to cut their their lives short for their families or society's best interest. She added that repeated sessions would be required every time a Medicare recipient got sick. PolitiFact called her statements as a "ridiculous falsehood", ("Pants on Fire" on their "Truth-O-Meter" scale), stating that the bill did not require the counseling sessions and describing McCaughey's claim that the sessions would "tell [seniors] how to end their life sooner" as an outright distortion. McCaughey also said, "These are such sacred issues of life and death. Government should have nothing to do with this." McCaughey was joined in spreading these ideas by other pundits and conservative media that had helped defeat the Clinton era legislation, including The Washington Times and The American Spectator.

Both McCaughey and Palin's remarks about what Palin called an 'death panel' were based on opinions about Ezekiel Emanuel as well as proposed Medicare funding for living wills. McCaughey also said that presidential advisor Dr. Ezekiel Emanuel thought that the disabled should not be entitled to medical care, which, according to The New York Times was a false claim that helped inspire Palin's warnings about "death panels". Emanuel is in fact an opponent of legalization of doctor-assisted suicide or euthanasia. FactCheck.org said, "We agree that Emanuel’s meaning is being twisted. In one article, he was talking about a philosophical trend, and in another, he was writing about how to make the most ethical choices when forced to choose which patients get organ transplants or vaccines when supplies are limited." Emanuel responded to the claims, telling TIME magazine, "'No one who has read what I have done for 25 years would come to the conclusions that have been put out there'", he said. "'My quotes were just being taken out of context.'" The bill did not become law, but if it had the measure would have blocked funds for counseling that presents suicide or assisted suicide as an option. According to Congressman Earl Blumenauer who sponsored the failed bill called references to death panels or euthanasia were "mind-numbing".

Representative John Boehner (Republican-Ohio), then the Minority Leader of the U.S. House of Representatives, was described by The New York Times as a leader in the spreading of unsubstantiated claims that Section 1233 would encourage euthanasia. Along with Representative and Republican Policy Committee Chairman Thaddeus McCotter (Michigan), Boehner stated in a July 23 statement that the provision "may start us down a treacherous path toward government-encouraged euthanasia". FactCheck.org referred to this as "a stretch" and Representative Earl Blumenauer (Democrat-Oregon) took issue with the claim. On July 28, on the House floor, Representative Virginia Foxx (Republican-North Carolina) said a Republican alternative to the Democratic reform proposals was "pro-life because it will not put seniors in a position of being put to death by their government". On July 30, Newt Gingrich, who has praised the Gundersen Lutheran Medical Center for its end-of-life practices, told reporters after a speech at Gunderson Lutheran that the House bill had "a bias toward euthanasia for senior citizens and other people". Gundersen officials were dismayed after Gingrich was critical of section 1233, which Gundersen helped craft, as Gingrich was satisfied with the end-of-life care his father-in-law received there.

The Washington Post noted on August 1 that

“on right-leaning radio programs, religious e-mail lists and Internet blogs, the proposal has been described as 'guiding you in how to die,' 'an ORDER from the Government to end your life,' promoting 'death care' and, in the words of antiabortion leader Randall Terry, an attempt to 'kill Granny.'”

First use

On August 7, Palin coined the term on her first Facebook page posting, stating:

“The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil.”

Spread during 2009

According to a study by Brendan Nyhan published in The Forum of Berkeley Electronic Press, during the period of July 16 through August 14, the death panel myth was spread mainly by "conservative outlets on cable news, talk radio, and the internet", including:

According to the BBC, conservative blogger Michelle Malkin "explicitly" agreed with Palin's statement that death panels were mandated in Obama's proposed legislation. Former House speaker Newt Gingrich backed Palin during his August 9, 2009 appearance on This Week with George Stephanopoulos when he remarked that the 1000 page bill provides for many panels. "You're asking us to trust turning power over to the government, when there clearly are people in America who believe in establishing euthanasia, including selective standards", he said. Health economist Uwe Reinhardt responded Gingrich should clarify that the health care bill's provision for reimbursing physicians for counseling on advanced directives was far removed from 'death panels' or an intent to shorten life, noting that Gingrich had previously supported the expanded use of advance directives.

At an August 12 town hall meeting, Republican Senator Chuck Grassley, said people

“have every right to fear .... I don't have any problem with things like living wills, but they ought to be done within the family. We should not have a government program that determines you're going to pull the plug on Grandma.”

On August 12, Palin posted another note on her Facebook standing by her earlier claim and charging that "the elderly and ailing would be coerced into accepting minimal end-of-life care to reduce health care costs". Palin also wrote that it was misleading for Obama to say the sessions would be entirely voluntary. PolitiFact.com responded that Palin's assertion was false and that the sessions were voluntary.

Legislation

When asked exactly what part of the proposed legislation mandated death panels, Palin's spokesperson pointed to H.R. 3200, section 1233 Advance Care Planning Consultation. The provision would have allowed physicians to receive payment from Medicare for voluntary counseling with patients regarding end-of-life issues so that personal preferences for care when the time comes would be known so that doctors and relatives would not have to make decisions about care on their behalf. The counseling would cover topics such as making living wills, enabling a close relative or a trusted friend to make health care decisions, hospice as an option for the terminally ill, and information about pain medications for chronic discomfort. The sessions would have been covered by Medicare every five years or more frequently for patients who became gravely ill. Supporters of the provision included the American Medical Association, AARP, the National Hospice and Palliative Care Organization, and Consumers Union; the National Right to Life Committee opposed "the provision as written".

The provision was inserted in the bill by Democratic lawmakers at the behest of La Crosse Wisconsin hospitals, including Gundersen Lutheran, that created a pioneering community program to get people who were not critically ill, to think about and choose the treatments they would want at the end of life. Before H.R. 3200, Representative Earl Blumenauer (Democrat-Oregon) had submitted single purpose legislation in April 2009 with Republican cosponsors—Charles Boustany (Louisiana), a cardiovascular surgeon, Patrick Tiberi (Ohio), and Geoff Davis (Kentucky)—that similarly provided for Medicare payments to doctors for end-of-life counseling with patients. In 1991 the Patient Self-Determination Act was enacted which required health care providers, including hospitals, hospices, and nursing homes to provide information about advance directives to admitted patients.

Consultation payments were removed from the Senate version of the bill while remaining in the House version until November 2009, when they passed, but they did not pass in the final bill. On December 25, 2010, The New York Times reported that effective January 1, a new Medicare regulation had been added for consultations during annual "wellness visits," instead of at 5 year intervals as the bill originally mandated. Instead, on January 4, The New York Times reported the payments would be struck from the regulations.

Uses

According to The Economist, the phrase was used as an "outrageous allegation" to confront politicians at town hall meetings during the August 2009 congressional recess. According to The New York Times, the term became a standard slogan among many conservatives opposed to the Obama administration’s health care overhaul. Health law and bioethics expert George J. Annas wrote that "make believe 'death panels' that would 'pull the plug on grandma' were used as a rhetorical device to block any rational discussion of either death generally, or end of life care in particular". Brent J. Pawlecki, a corporate medical director, said the phrases death panels and "killing Grandma" were "used to fuel the flames of fear and opposition". Former Newsweek editor Jon Meacham said it was "a lie crafted to foment opposition to the president's push for reform".

Health economist Uwe Reinhardt said that it is possible to slightly bend the U.S. health care cost curve down through a lower volume of health care services "by more widespread use of living wills—an idea once actively promoted by Newt Gingrich. But those ideas were met in the past year by dark allusions to 'rationing', to Nazi-style death panels and to 'killing Granny'". Reinhardt said lowering health care costs require lowering health care incomes, and those reforms always end up being a political third rail.

Rationing

Economist Uwe Reinhardt, noted that rationing health care on the basis of price has been going on for years in the United States, saying "free markets are not an alternative to rationing. They are just one particular form of rationing." He criticized reform opponents who "would have us believe that only governments ration things" and when private insurers reject claims or have a high coinsurance rate that causes patients to forgo care, that the insurers are not rationing health care. He also described the main purpose of Obama's health care reforms as "to reduce rationing on the basis of price and ability to pay".

Michael F. Cannon of the Cato Institute wrote that "[p]aying doctors to help seniors sort out their preferences for end-of-life care is consumer-directed rationing, not bureaucratic rationing". The Christian Science Monitor reported that some Republicans used the term as a "jumping-off point" to discuss government rationing of health care services, while some liberal groups applied the term to private health insurance companies. Newt Gingrich, a Republican, said that while technically, the proposed legislation (H.R. 3200) did not provide for government rationing of health care, he alleged the legislation was "all but certain to lead to rationing".

Brendan Nyhan, a health care policy analyst at the University of Michigan, wrote that although "efforts to reduce growth in health care costs under Obama’s plan might lead to more restrictive rationing than already occurs under the current health care system", Palin's statement as a whole was unjustified and false. Nyhan also sees attempts to label institutions which deny "coverage at a system level for specific treatments or drugs" as attempts to move the goalposts of the debate as Palin's language required that a 'death panel' "would determine whether individual patients receive care based on their 'level of productivity in society'" which "was—and remains—false".

Reactions and analysis

Bioethicist George Annas writes that America has a "death denying culture that cannot accept death as anything but defeat". We will "prepare for any and every disease and screen for every possible 'risk factor', but we are utterly unable to prepare for death". Annas commends and quotes Boston Globe columnist Ellen Goodman, who writes "I think that what our [healthcare] system may need is not more intervention, but more conversation, especially on the delicate subject of dying ... More expensive care is not always better care. Doing everything can be the wrong thing. The end of life is one place where ethics and economics can still be braided into a single strand of humanity". However, Annas says mythical death panels blocked exploring these issues, appearing to affirm Ivan Illich's 1975 Medical Nemesis, when he said "'[s]ocially approved death happens when man [sic] has become useless not only as a producer but also as a consumer. It is at this point that [the patient] ... must be written off as a total loss'".

Health economist James C. Robinson said the "debate over so called death panels" showed how willing the public was "to believe the worst about perceived governmental interference with individual choices". Historian Jill Lepore characterized 'death panels' as a reborn "conspiracy theory" that is believed by a minority of the U.S. population after Roe v. Wade and the Karen Ann Quinlan case—that the federal government is conspiring to kill off its weakest members. Of the reform effort, Lepore said it was an "unwelcome reminder of a dreaded truth: death comes to us all" of the uproar, Lepore said it rallied a party base against death, making "for a creepy sort of populism. But if harnessing the fear of death for political gain is a grotesque tactic, it may also be a savvy one". Lepore noted that after the story spread, when Obama was left saying he was not in favor of death panels, it was an example of being "catastrophically outmaneuvered". Political scientist James Morone said that despite Democrats denying the charge and focusing on the facts, the term played a role in their loss of control over the public debate because they did not address the "underlying fears of big government". Morone called the death panel arguments "pungent, memorable, simple, and effective". Journalist Paul Waldman of The American Prospect, characterized the charge as a consequential policy lie, a falsehood that is not as condemned in media as an inconsequential personal lie.

, a health adviser to President George H.W. Bush and John McCain who has overseen Medicare and Medicaid, said the charge was untrue and upsetting. She said "[t]here are serious questions that are associated with policy aspects of the health care reform bills that we're seeing ... And there's frustration because so much of the discussion is around issues like the death panels and Zeke Emanuel that I think are red herrings at best". , editor of Health Affairs, said Congress' approval of $1.1 billion for comparative effectiveness research in the 2009 stimulus contributed to fear the research would "lead to government rationing" which "fueled the 'death panels' fury of summer 2009".

Physicians

The Ethics Committee and Taskforce on the Cost of Cancer Care of the American Society of Clinical Oncology said in a statement that the issue of funding discussions with patients had been "unfortunately politicized".

“Currently, our system highly incentivizes delivery of cancer-directed interventions (chemotherapy, targeted therapy, and so on) over conversations that are critical to establishing a patient’s goals and preferences and providing individualized care. Efforts to compensate oncologists and others for delivering this important aspect of cancer care were unfortunately politicized in the recent health care reform debates, but these efforts had at their core a critical patient-centered societal interest and should be revisited.”

Geriatric psychiatrist Paul Kettl wrote

“I wish we had death panels. I don’t mean that I’m in favor of some appointed group of erudite experts gathering to decide who lives or dies in a process controlled by the government, but rather the death panels that were originally proposed. I’m in favor of periodic discussions about advance directives that Medicare would pay for as medical visits.”

Kettl said his experience in a geriatric unit showed end-of-life discussions and reimbursements were "desperately needed" as these hour long conversations are "ignored in the crush of medication and disease management". Kettl noted that the attention-catching phrase death panels became "a lightning rod for objections to a series of ideas about health care besides" end-of-life discussions, and that somehow, "the concept of physicians being paid for time to talk with patients and their families about advance directives ... generated into the fear of decisions about life and death being controlled by the government". Kettl wrote that

“Emotions and health care go together. That makes them an easy and consistent target for the media and for grandstanding commentators. We can expect more good medical ideas to be destroyed by sound bytes and needless concerns that will be exaggerated. It makes for good television, but bad medicine.”

Dr. Benjamin W. Corn, a cancer specialist, said the death panels controversy showed Americans were uneasy discussing topics related to the dying process and he argued that certain issues, such as whether experimental therapies should be reimbursed, the possible expansion of hospices, restoring dignity to the process of dying, and guidelines for physician assisted suicide, need to be addressed directly. Dr. David Casarett, a physician who teaches palliative care at the University of Pennsylvania, responded to the 'death panels' and euthanisia charge by saying

“I'm still mystified. I really can't begin to figure out where this language is coming from. It bears really no resemblance to what's in the provision of the health-care reform bill. What's in the health-care reform bill is in general, text that I think most Americans and certainly all of my patients would support.

The text of the bill really talks about giving patients and families the information they need to make the right choices. It's about giving patients an idea of what their options are. And it's giving patients and families a chance to talk about these things. So patients, families and physicians are all on the same page.

Really, these sorts of discussions are about autonomy. They're about freedom. They're about independence. They're about having a say in your own health care. They're about values that are about as American as anything else I can think of.

And so, to see this debate framing it in terms of some of the terms you mentioned before—death panels and euthanasia—is really both odd and frankly, startling to me that it's gone that far.

”

Dr. Atul Gawande, a surgeon who writes about medical topics, told NPR that end of life conversations in the health reform bill "got mutated into" being described as death panels. Dr. C. Porter Storey Jr. thinks the term represents "fear that there ... is not enough money to do everything for everybody and that some mechanical, governmental method will be used to determine how much of our scarce health care resources will be applied to their situation".

Politicians

U.S. Senator Lisa Murkowski (Republican-Alaska) told a crowd in Anchorage in August 2009, "It does us no good to incite fear in people by saying that there's these end-of-life provisions, these death panels". She added, "There is no reason to gin up fear in the American public by saying things that are not included in the bill".

In a July 2010 National Public Radio segment entitled "The Politics Of Anger", Representative Bob Inglis, (Republican-South Carolina) said, "I think it's never a good strategy to travel on misinformation. Talking about death panels when there are no death panels is a disservice to the country and, long-term, to the conservative movement."

Representative Earl Blumenauer (Democrat-Oregon) thought the "'death panels' episode" showed that the news media amplified misinformation and extreme behavior instead of simply reporting the facts, contributing to the persistence of the falsehood. When a regulation for reimbursing consultation payments was upcoming, Blumenauer cautioned supporters that the "regulation could be modified or reversed, especially if Republican leaders try to use this small provision to perpetuate the 'death panel' myth... We would ask that you not broadcast this accomplishment out to any of your lists, even if they are 'supporters'—e-mails can too easily be forwarded".

Representative Darrell Issa (Republican-California) said he agrees with the perspective of his colleague, Representative Charles Boustany (Repulican-Louisiana), a surgeon. Referencing Boustany, Issa said that "'medical panels of people who care about what's best for their patients' and about appropriate procedures 'is good science and good medicine'". Issa also said that, "Republicans have to step back from the words 'death panels'".

Palin's responses

In a September 2009 speech in Hong Kong, Palin said the term was "intended to sound a warning about the rationing that is sure to follow if big government tries to simultaneously increase health care coverage while also claiming to decrease costs". In November 2009 Palin said that Obama was "incorrect" and "disingenuous" when he called the death panel charge "a lie, plain and simple". In the National Review she said

“[t]o me, while reading that section of the bill, it became so evident that there would be a panel of bureaucrats who would decide on levels of health care, decide on those who are worthy or not worthy of receiving some government-controlled coverage ... Since health care would have to be rationed if it were promised to everyone, it would therefore lead to harm for many individuals not able to receive the government care. That leads, of course, to death.”

She explained that the term should not be taken literally, likening it to when President Ronald Reagan called the Soviet Union, the "Evil Empire". "He got his point across. He got people thinking and researching what he was talking about. It was quite effective. Same thing with the 'death panels.' I would characterize them like that again, in a heartbeat", she said. Media Matters stated that "Palin's claim of 'death panels' comprised of bureaucrats deciding who is 'worthy of health care' is simply false, regardless of whether she meant it literally or figuratively".

In October 2010, Palin defended her use of the term in a Newsmax.com interview. Palin said she

“spoke a lot about the rationing of care that was going to be a part of Obamacare, and, you know, I was about laughed out of town for bringing to light what I call death panels, because there's going to be faceless bureaucrats who will—based on cost analysis and some subjective idea on somebody's level of productivity in life—somebody is going to call the shots as to whether your loved one will be able to receive health care or not. To me, death panel. I called it like I saw it, and people didn't like it.”

Palin used the term in a joke while speaking at the 2009 Gridiron Club dinner, saying "It is good to be here and in front of this audience of leading journalists and intellectuals. Or, as I call it, a death panel."

Impact

Political

About a week after the coining of the term, consultation payments were removed from the Senate version of the bill by the Senate Finance Committee. TIME wrote that "a single phrase—'death panels'—nearly derailed health care reform". The Washington Post wrote that "President Obama's health-care initiative was nearly consumed by the furor" over the end-of-life care provision that would allow physician reimbursement for counseling.

Johnathan Oberlander, a professor of health policy, said "[t]he administration ... was seemingly unprepared for the intense opposition and fury that erupted during town-hall meetings in the summer of 2009. The Democrats' focus group–tested mantra of 'quality, affordable health care' was drowned out by Republicans' false warnings of 'death panels' and a 'government takeover'". Morone said the White House was not able to offer a "persuasive narrative to counter the Tea Party percussion", and "struggled to recapture public attention", contributing to Scott Brown's election.

By mid-August 2009, the Pew Research Center reported that 86% of Americans had heard of the "death panels" charge. Out of those who had heard the charge, 30% of people thought it was true while 20% did not know. For Republicans, 47% thought it was true while 23% did not know. In September 2010, six months after the passage of the Affordable Care Act, a BBC article stated that among the "sticky charges" that had stuck against the bill was the false charge of "government 'death panels' deciding who can get what sort of care". A survey by the and National Journal released in 2011 showed 40% of Americans knew that the 'death panels' were not in the Affordable Care Act, while 23% said they thought the law allowed government to make end-of-life care decisions on behalf of seniors, and 36% said they did not know. Other findings from the survey included:

Professional

In the wake of the 'death panel' controversy, Atul Gawande, a physician who writes on health care topics for The New Yorker, was asked to refrain from writing about palliative care by physicians who were concerned the article might be manipulated to create another political controversy—and as a result, hurt their profession.

Bishop et al. were fearful of how their publication on CPR/DNR would be received by the medical and bioethics communities. They were concerned because in "the era of rhetoric centered on fictional 'death panels'" their paper addressed "the quest for immortality implicit in US culture, a culture of 'life-at-all costs' that medical technology has advanced". Bishop et al. interpreted cautioning comments from their peers as a suggestion "that land mines of 'death panels' await us".

Lie and word of the year

PolitiFact.com gave Palin's term its highest rating—"Pants on Fire!"—on August 10 and on December 19 it was named "Lie of the Year" for 2009. "Death panel" was named the most outrageous word of 2009 by the American Dialect Society. The definition was given as "A supposed committee of doctors and/or bureaucrats who would decide which patients were allowed to receive treatment, ostensibly leaving the rest to die". FactCheck named the death panels falsehood as one of the "whoppers" of 2009.

Post-Summer 2009 uses of term

Arizona restrictions on Medicaid coverage

When it became known in 2010 that Arizona had passed legislation restricting Medicaid recipients access to funding for life saving transplant operations, some of which had already been approved. Some in the media were quick to label the politicians denying care "a death panel" pinning the blame on the Republican governor Jan Brewer and the state's legislature. The legislation was in support of a budget that had been planned before the passing of the Affordable Care Act 2010. Arizona is not the only State to have cut Medicaid coverage but none other had gone so far as cutting transplant access, which are considered optional under federal law.

IPAB

While the term originally targeted a end-of-life care provision, Palin later applied the term to the IPAB. After the National Commission on Fiscal Responsibility and Reform released its recommendation to strengthen the IPAB, she charged in the Wall Street Journal that the board was "'death panel'-like". FactCheck.org found her characterization of the board wrong on three counts. Representative Phil Roe (Republican-Tennessee), who has twice sponsored bills to eliminate the IPAB, said he would associate the term with the IPAB. Roe was described by the The Washington Post as "a kindred soul by the medical industry" in part for his legislative efforts against the IPAB and a "magnet during the last election for more than $90,000 in contributions from medical professionals from across the country".

Other mentions

In October 2010, The Philadelphia Inquirer highlighted the term in its "The Week in Words" article after Barney Frank said the only death panels created by congressional Democrats were for troubled financial institutions under the authority of the Dodd–Frank Bill.

In November 2010, Paul Krugman said that no death panels would be needed to control Medicare and Medicaid costs "through consideration of medical effectiveness and, at some point, how much we’re willing to spend for extreme care".

In his 2011 book, Mike Huckabee claimed that the Federal Coordinating Council for Comparative Effectiveness from the 2009 stimulus were the seeds from which "the poisonous tree of death panels will grow". The Media Matters called this a "lie" it reported that Huckabee mischaracterized the council and that it was eliminated in the 2010 health care reform. Paul Van de Water of the Center on Budget and Policy Priorities, said "Huckabee seems to be suggesting that we shouldn't do research to find out what medical procedures work best just because that research could conceivably be misused. The new law makes every effort to assure that won't happen."

Examples with similarities

When dialysis, a medical technology that performs the critical function of the kidney, was a new and expensive treatment in the U.S., most private insurers would not pay for the service. At one U.S. hospital, before the treatment was guaranteed through Medicare, a community—not government—panel, rationed the new technology based on several factors, one being perceived social worth. Doctors did not want to make the decisions as to which patients got the life-saving treatment, so community members made the decisions. ProPublica referred to the panel as a death panel, which was dubbed a "God Committee" by contemporaries. The hospital's panel, at Scribner's medical center, "sparked one of the earliest national debates over the right to care and put pressure on the government to step in."

A 2009 Foreign Policy article compared what they said was Palin's false death panel charge to three global health care policies. They each received a "death panel factor", or a score out of 100. Physician-assisted suicide programs in Switzerland, Luxembourg, Belgium, the Netherlands, and the U.S. state of Oregon garnered a 30. The Texas Futile Care Law received a 25. It "gives patients the right to dictate the kind of end-of-life care they would like to receive. But the law contains a provision allowing a hospital committee to arbitrate disputes between families and physicians. The boards can end life support for patients if the care is determined to be 'futile'". Britain's NICE, "which sets standards for its National Health Service by evaluating medications and approving those found to be cost-effective" received a rating of 15.

A 2011 editorial by USA Today said, "to the extent that death panels of a sort do exist, they're composed of state officials who must decide whether each state's version of Medicaid will cover certain expensive, potentially life-saving treatments".

See also

References

External links






Retrieved from : http://en.wikipedia.org/wiki/Death_panel
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