walkitout (walkitout) wrote,

betsy mccaughey (sounds like mccoy, may still be spelled wrong)

Stewart had her on the Daily Show as the last interview before the 3 week break. I don't much care for people like this getting any kind of platform at all, and I vastly prefer listening to reasonable people be interviewed on the shows I liked to watch. That said, it was probably useful to hear what this woman is actually telling people.

What she is saying is simple: the house bill had (it has since been removed) a section on reimbursing doctors to help their patients will the living will process (she actually mischaracterized it repeatedly, which Stewart did pick up on) and that section included principles for assessing doctors/hospitals/etc. performance based on their adherence to what comes out of that process (she also mischaracterized this part repeatedly, and Stewart picked up on that as well). She thinks that is bad, and here is why. What if you say, DNR, then you come in and go, no, please resuscitate me! Or, in her words, "Hurry!" She thinks that if health care providers are assessed on compliance with living wills, they would somehow not provide adequate care _to a patient who was in trouble and able to request help_.

Stewart (in the part that was aired) did not focus on this ridiculousness. Of _course_ a living will does not apply if you can talk! A living will exists for two reasons: to stop health care providers from identifying you as a person who is Good For It (alive or dead) and therefore breathing (intubating, etc.) the meat as long as possible to juice the bottom line), and to put some limits around the capacity of family members to completely sabotage the remaining family relationships as a result of jockeying for whatever each of them thinks is the Right Thing to Do to your vegetative body. Living wills and other documents are so problematic in terms of enforcement that they don't _really_ stop lawsuits from happening; that's just a dream in the eyes of optimists.

The idea that a living will might somehow ever gain so much power that it could have any impact whatsoever on someone who is capable of saying something (really, anything at all) is crazy-stupid-misleading-creepy. Particularly so, since there were so many people in the Schiavo case prepared to interpret random facial gestures as somehow meaningful.

I desperately want health care powers of attorney, living wills, etc. to have meaning. When people do things like what B.M. here is doing to render them even more tissue paper like in their capacity to Stop Bad Behavior on the part of the health care industry, it makes me cranky. Really, really, really cranky.

And that's completely ignoring how when living wills are actually adhered to (and this is an issue -- hospitals blow right through DNRs so often that people try having them magic markered on their chests when it gets close to the end), families do better, and there's some reason to believe the death is better in the sense of it not being as painful, and not as much of a rape-like experience as it all too often is in hospitals.

Notice I never mentioned a thing about cost here. Being reasonable is also cheaper than being stupidly pro-technology at end-of-life. But that's not a moral argument and for this, I think the moral argument is more compelling.
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