In the medical field, each service provided is reimbursed (payment being based on level of complexity, time required etc). If there is no reimbursement for something, then one is not obliged to provide it. According end of life counseling reimbursement shows that it is considered necessary and important in its own right, not as a half-sentence wedged into a medical interaction on other matters. It also means that the doctor will get paid if someone who is not otherwise ill, wants to see him to discuss end of life care (a very wise thing to do in this day and age). As it stands right now, many people sometimes sign these directives or wills with little understanding of what they are refusing or insisting on. How anyone can see something sinister in changing that state of affairs is beyond me.
With regards to Christians being part of the process, let’s start with making sure that enough of us are getting into the relevant areas of medicine/research etc. It is certainly better to be proactive than reactive. Like I said, such professional bodies already exist - we have the power to decide whether or not we get on board that train before it leaves the station for good.
Doctors are obliged to fully inform their patients concerning the nature and consequences of any significant condition that manifests itself. And I don’t doubt most do, since they could be subjected to Board complaints, at minimum, if they did not.
But that’s not the same thing as getting into a conversation about “end of life choices” when, for example, a person is simply elderly and nothing more.
Nor is there any particular reason to expect doctors to understand the documents much better than laymen do. I know a number of doctors, and I certainly would not testify to their having a high degree of legal knowledge, (and those documents do have a legal effect) and their ethical principles vary as much as anyone else’s. They’re not counselors either, for the most part, and asking a doctor to engage Aunt Suzie in a discussion about “end of life care” when all she is is old, is beyond the pale of what most doctors are in any way trained to do or, in my opinion, should do. “You see, Aunt Suzie, you’re old, and you’ll get more and more frail, and you might get to where you can’t walk, perhaps are incontinent or in pain, or all of those things.” (As if Aunt Suzie doesn’t already know those things.) “And you see, you can have certain palliative measures, or perhaps not elect life-saving measures in order to end it, and then there’s…”
So will most doctors “farm that out” to some organization that does it? I would bet on that rather than against it. Will the remainder receive some kind of “guidelines” from HHS? I would also bet on that sooner than against it. And what will the “guidelines” say to tell Aunt Suzie about her “end of life choices”, understanding that Suzie is no less subject to suggestion in the doctor’s office than she is at home and that the doctor is no less ethically and morally at sea if he’s paid to do it than if he’s not, but doesn’t want to be criticized for failing to give her “full information” provided by HHS. He’ll be audited, of course, concerning his “completeness” in giving “full information”, or he’ll be concerned that he will. So, he’ll opt for the HHS version. Perhaps Suzie will need to sign it to show that he did.
People died long before Obama came along, and most of them anymore see it coming. I’m persuaded that most doctors know what to tell people about their condition, and do tell them. But the documents themselves are a lawyerly function, not a doctor’s thing to do. What is Suzie really trying to do when she signs? What does she want to cover, to add, to subtract? And they’re a priestly function, or a clergyman function, to the extent those decisions have a moral content. What moral guidance is to be given? Is the doctor really the one to be giving it? Or is he or some surrogate going to rely on the government’s “guideline suggestions” for that? The guidelines of a government that presently at least, is fine with abortion on demand to eliminate “unwanted” children, and the guidelines of a Secretary of HHS who was fine with partial birth abortion, and those of a president who didn’t want to restrict infanticide-by-neglect? The government did push “end of life guidelines”, you know, or at least started it with the military, and “ending it” was part of the pitch. But it was withdrawn when some people in congress protested. So now it’s good for everybody?
Some may wish to trust this death-canoodling government with such things. But I don’t. And saying “Christians have to become involved” in the face of placing yet more power in the hands of such a government is, in my judgment, just as futile as saying “the way to end abortion on demand is to convince the public that it should end”. Trouble with that one is that most people don’t support abortion on demand, but it doesn’t do a bit of good that they don’t.
Rather than “Christians have to become involved” in a government that’s pagan to the core, I prefer “Government should NOT become involved.” Then we don’t have to wonder how on earth true Christians are going to wedge themselves into something in which there is no possibility that they will be welcome. Does anyone really think that the likes of Kathleen Sebelius who preferred excommunication (and got it) rather than abandon her love for abortion, will welcome prolife Christians into the decisionmaking process with this? Some may want to dream up that scenario, but I’m not willing to do it.
