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    Veterans Adminstration's 'Living Will' Assistance . . .

    image Did anyone catch these?


    On "Fox News Sunday," H. James Towey, the director of the White House Office of Faith-Based and Community Initiatives under President George W. Bush, said the guide seemed to encourage people to "hurry up and die."

    The booklet, "Your Life, Your Choices," asks people to consider whether life would be worth living if, for example, they were in severe pain, relied on a feeding tube or a breathing machine, lived in a nursing home or imposed "a severe financial burden" on family members.

    In a bulletin last month, the Department of Veterans Affairs recommended the booklet as a tool to help veterans with "advance care planning."

    Tammy Duckworth, an assistant secretary of veterans affairs, said it was being revised.

    But Mr. Towey said, "The document is so fundamentally flawed that the V.A. ought to throw it out."

    nytimes.com/2009/08/24/health/policy/24health.html

    And also -- now over at...

    TPM LiveWire

    Jonah Goldberg Compares VA Pamphlet to Nazi Eugenics
    By Rachel Slajda - August 24, 2009, 11:14AM

    Jonah Goldberg, editor-at-large of National Review Online, went on Fox News today to fan the flames of the latest fabricated "death panel" controversy.

    Goldberg equated a Veterans Affairs pamphlet -- one that's reportedly no longer being used -- with Nazi eugenics, saying "death panels may not be too far off the horizon."

    Read the entire TPM LiveWire report.

     

    The following is the opening to the booklet in question...



    ================ begin snippet ===================


    Your Life, Your Choices:

    Planning for Future Medical Decisions

     

    Note -

     

    The following is a 1997 publication that was produced under VA IIR Grant No. 94-050, "Development of an Advance Care Planning Workbook," 4/01/95 - 3/31/97. The document is currently undergoing revision for release in VA. The revised version will be available soon.

     

     

    Your Life

    Your Choices

     

    Authored by

    • Robert Pearlman, MD MPH
    • Helene Starks, MPH
    • Kevin Cain, PhD
    • William Cole, PhD
    • David Rosengren, PhD
    • Donald Patrick, PhD MSPH

    Design & Layout by

    • Brems Eastman & Partners
    • Information Design Seattle

     

    Planning for Future Medical Decisions:

     

    How to Prepare a Personalized Living Will

     

    "What should we do for Dad?"

     

    Your Life, Your Choices

     

    There's only one person who is truly qualified to

    tell health care providers how you feel about

    different kinds of health care issues--and that's you.

     

    But, what if you get sick, or injured so severely that

    you can't communicate with your doctors or family

    members? Have you thought about what kinds of

    medical care you would want? Do your loved ones

    and health care providers know your wishes?

     

    Many people assume that close family members

    automatically know what they want. But studies

    have shown that spouses guess wrong over half the

    time about what kinds of treatment their husbands

    or wives would want.

     

    You can help assure that your wishes will direct

    future health care decisions through the process of

    advance care planning.

     

     

    "We got the kind of call we'd feared. Dad had

    been in declining health for months. Then he fell

    asleep at the wheel and was in a bad car accident.

    Three weeks later he was still in a coma. A breathing

    machine pumped air into his lungs because he could

    not breathe on his own. The doctors thought his

    chances of coming out of the coma were slim. They

    talked with Mom and me about turning off the

    breathing machine and allowing Dad to die naturally.

    I felt terrible. I didn't think Dad would want to be

    kept alive like this. But I knew Mom would feel guilty

    for the rest of her life if we told the doctors to "pull

    the plug" while there was still even the slightest hope.

    We weren't sure what we should do because Dad

    never told us what he would have wanted. I really

    wish we'd talked about this before."


    1. Figure out what you want.

     

    Think. You need to understand what kinds of

    situations you might face and the options for care.

     

    Write. Write down your wishes so your loved ones

    will have a record of what you told them. This also

    helps if no one is around who can

    speak for you.

     

    What do you need to do to guide your future health care?

     

    Forms are included in the back of this workbook.

    It can take as little as 15 minutes to fill them out.

     

    2. Communicate this to others.


    Talk. Tell your loved ones and health care providers

    about your strongly-held beliefs and what kinds of

    care you would want in different situations.

     

    Part I: The Basics. This 14-page section introduces and discusses

    all of the important components of advance care planning. You

    may find it provides enough information for you to figure out

    what you want and express your wishes to others.

     

    Part II: Resources. Turn to these sections for additional help and

    further explanation of ideas and topics introduced in "The Basics."

     

    Two ways to use this book.


    Spend an hour working through "The Basics." Then communicate.

    OR

    Work through "The Basics." Take another hour or two to work

    through all or part of "Resources" for a more complete approach.

    Then communicate.

     

    How to use this workbook.

     

    This workbook has two parts.

     

     

    TABLE OF CONTENTS

    The Basics

    Why do you need to think now about future health

    care decisions? ......................................................................... 5

    Do you have strongly-held beliefs that should guide

    your care? ................................................................................ 6

    If you couldn't speak for yourself, what would you

    want done for you? ................................................................... 7

    Who will speak for me if I can't speak for myself? ....................... 8

    Common questions about choosing a spokesperson.................... 9

    What else can I do to make my wishes known? ....................... 10

    Common questions about advance directives ........................... 11

    What situations and decisions do people commonly face?

    Dementia ............................................................................. 12

    Coma .................................................................................. 13

    Stroke ................................................................................. 14

    Terminal illness .................................................................... 15

    Telling others what you want ................................................. 16

    Writing it down ..................................................................... 17

    What's next? ....................................................................... 18

     

    Thought-provoking exercises


    Introduction.. ...................................................................... 19


    Your Beliefs and Values

    Who should speak for me? .................................................... 20

    What makes your life worth living?........................................... 21

    Personal and spiritual beliefs ................................................. 22

    Hope for recovery .................................................................. 23

    Weighing pros and cons of treatment

    for different chances of recovery ............................................. 23


    Choices about death and dying

    How would you like to spend your last days? ......................... 24

    Organ donation and autopsy.................................................. 25

    Burial arrangements ............................................................. 25

    Funeral or memorial services ................................................ 26

     

    Health conditions and treatments


    Introduction .. ................................................................... 27


    Health conditions

    Coma................................................................................. 28

    Dementia ........................................................................... 29

    Serious stroke .................................................................... 30

    Terminal illness .................................................................. 31


    Treatments

    Kidney dialysis .................................................................. 32

    CPR-Cardiopulmonary Resuscitation ................................... 33

    Feeding tubes ................................................................... 34

    Mechanical ventilators (breathing machines) ........................ 35

    Hospice and palliative care ................................................. 36

     

    Your health care preferences


    Introduction.. .................................................................. 37



    Care preferences under different health conditions

    Current health.......................................................................... 38

    Permanent coma ..................................................................... 39

    Severe dementia ..................................................................... 40

    Severe stroke .......................................................................... 41

    Terminal illness ....................................................................... 42

    A future situation of concern..................................................... 43

     

    How to talk about your wishes


    Introduction. ........................................................................ 45


    Talking about your wishes

    Starting the discussion .......................................................... 46

    Asking someone to be your spokesperson .............................. 47

    Who else should you talk to? ................................................. 47

    What if you don't have close family or friends? ......................... 47

    Nine important issues to discuss ........................................... 48

    Talking to your health care providers ...................................... 49

    Reviewing you wishes ........................................................... 50


    Other issues

    Legal and ethical issues of advance care planning .................. 51


    ================ end snippet =======================


    The complete booklet is in PDF form at the following link:

    ethics.va.gov/YLYC/YLYCFirstedition_20001001.pdf


    I've provided this to allow you the individual to make a reasonable effort to understand and judge for yourself what is in the booklet and not rely on the words of Jonah Goldberg or Bush's Faith-Based lackey, H. James Towey.

    See full size image

    In their golden daze ....

    ~OGD~


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