Pall - A Word Worthy Of Reflection

August 18, 2009 09:00 AM

Over this past weekend a good friend, Paul Byrne, M.D., sent an interesting comment my way. He pointed out that one of the root words of palliative is pall.

I checked it in my trusty Merriam-Webster's dictionary and found the following:

2b (1): a heavy cloth draped over a coffin (2): a coffin especially when holding a body
3a: something that covers or conceals; especially: an overspreading element that produces an effect of gloom <a pall of thick black smoke> <a pall of suspicion> b: a feeling of gloom <his absence cast a pall over the celebration>

In the context of the ongoing debate regarding whether or not a form of euthanasia may appear in the final version of the nationalized health care [insurance] reform bill, this word has a connotation which cannot be ignored. It has already been shown that palliative care can be used to either relieve pain or expedite a quick exit for the patient. It all depends on who is administering the medicine and whose orders are being followed.

The Pontifical Council for Pastoral Assistance for Health Care Workers wrote the following in the seminal document, Charter for Health Care Workers, in addressing “The use of painkillers for the terminally ill” in Chapter III, 246:

Sometimes the systematic use of narcotics which reduce the consciousness of the patient is a cloak for the frequently unconscious wish of the health care worker to discontinue relating to the dying person. In this case it is not so much the alleviation of the patient's suffering that is sought as the convenience of those in attendance. The dying person is deprived of the possibility of "living his own life", by reducing him to a state of unconsciousness unworthy of a human being. This is why the administration of narcotics for the sole purpose of depriving the dying person of a conscious end is "a truly deplorable practice."

It is a different matter when there is a serious clinical case for the administration of analgesics which suppress consciousness, as when there is violent and unbearable pain. In this case the anesthetic is said to be licit, provided certain conditions are fulfilled: that the dying person has fulfilled or could still fulfill his moral, family and religious obligations.

In other words, the very same medication that can bring relief can also be used to kill. It’s not that difficult to comprehend. This is but one reason to be concerned that current discussions relating to Obamacare could lead to some pretty unfathomable horrors.

All anyone has to do is pay close attention to the discussions regarding end-of-life care. It is not beyond the pale to imagine that in one form or another, euthanizing the older generation may become one of those cost-cutting activities that cannot be avoided.

Consider the recent comments of author-screenwriter Richard Dooling, who is clearly no health care expert. Be that as it may, he weighed in with these acrid words in a New York Times commentary: 

One thing’s for sure: Our health care system has failed. Generational spending wars loom on the horizon. Rationing of health care is imminent.

I am not, of course, talking about euthanasia. I’m just wondering why the nation continues incurring enormous debt to pay for bypass surgery and titanium-knee replacements for octogenarians and nonagenarians, when for just a small fraction of those costs we could provide children with preventive health care and nutrition. Eight million children have no health insurance, but their parents pay 3 percent of their salaries to Medicare to make sure that seniors get the very best money can buy in prescription drugs for everything from restless leg syndrome to erectile dysfunction, scooters and end-of-life intensive care.

Then there’s Ross Douthat, who wrote about the enormity of the "burden" created by overspending Medicare dollars:

And if you think reform is tough today, just wait. We’re already practically a gerontocracy: Americans over 50 cast over 40 percent of the votes in the 2008 elections, and half the votes in the ’06 midterms. As the population ages — by 2030, there will be more Americans over 65 than under 18 — the power of the elderly and nearly elderly may become almost absolute.

In this future, somebody will need to stand for the principle that Medicare can’t pay every bill and bless every procedure. Somebody will need to defend the younger generation’s promise (and its pocketbooks). Somebody will need to say “no” to retirees.

Both of these writers did not mention other citizens whose care can be very costly. For example, the extremely premature baby who is born with specific problems caused by early birth, or the newborn with critical problems requiring special attention, or the individual who suffers a severe disability due to accident or genetic anomaly. In each of these cases, large sums of money are required to treat them. What about their future under regulated health care spending? Based on the sensitivities being expressed toward spending too much on certain types of treatment, it isn’t difficult to imagine that those I have just mentioned could also be required to make sacrifices for the greater good of a culture committed to financial savings over life saving.

It’s all about “quality of life” after all, and some people are, well, expendable!

When Obama spoke to a gathering of 50 Americans at an AARP gathering, he recommended that they consider his suggested reforms to the Medicare program as fiscally responsible and necessary in today’s economy. Among Obama’s preferences is the Independent Medicare Advisory Committee. IMAC has been defined as a group of individuals who would oversee how Medicare is administered and would recommend ways to make it more efficient. Some have suggested that such a committee could recommend health care rationing based on cost cutting. Washington Post political commentator David Broder wrote, 

Obama's proposal almost certainly would accelerate change in the way health care is delivered -- and it might actually save money in the long run.

But Congress will have to decide if it is willing to yield that degree of control to five unelected IMAC commissioners. And Americans will have to decide if they are comfortable having those commissioners determine how they will be treated when they are ill.

Without belaboring this point, it is wise and prudent to step back and examine the ramifications of any proposal in view of the groups of citizens for whom the proposal could have life-altering effects. For as Mark Steyn wrote recently,

The problem with government health systems is not that they pull the plug on Grandma. It's that Grandma has a hell of a time getting plugged in in the first place.…This ought to be of particular concern to Americans. As is often pointed out, U.S. life expectancy (78.06 years) lags behind other developed nations with government health care (United Kingdom 78.7, Germany 78.95, Sweden 80.63). So proponents of Obamacare are all but offering an extra "full year" of Euro-Canadian geriatric leisure as a signing bonus.

While some might think that Steyn is flippant about the problem that is confronting our nation, I would counter by suggesting that at least Steyn is talking about it! It is a provocative subject, and the more that is said about it, the better. There is still time, at this point, to stop such madness, but first the electorate has to realize that the White House smoke-and-mirrors show has another agenda, and it’s not a pretty one.

Leave it to Pat Boone, a dear friend and outspoken critic of Obamacare, to set the tone. He explains it is not just the "radicals" who are beginning to tell the truth about Obamacare:

•    Congress plans to pay for this "reform" by cutting $500 billion from Medicare. –Washington Post (July 16)
•    There will be long waits for care. –USA Today (July 17)
•    There will be cuts to MRIs, CAT scans and other vital tests. –Associated Press (June 24)
•    Seniors will lose their choice of doctors. –New York Times (April 2)
•    Government bureaucrats – not doctors – will decide if older patients are worth the costs of care. –Los Angeles Times (June 25)

Friends, these are not "right-wing" talk-show hosts holding the president's feet to the fire – these are some of the most liberal media outlets in the country! Even they are realizing that this bloated, misleading and outrageous scheme will set the stage, in actual practice and predictable bureaucratic perversion, for Orwellian governmental control over who gets care and what kind. They factually have to report that it's IMPOSSIBLE to cut Medicare by $500 billion and still provide for the 40 million more baby boomers who are coming into eligibility! The president's analysts say they can – but ordinary citizens know it's IMPOSSIBLE.

Obamacare is having the expected effect on the general population. The pall has been placed over the truth, and the unsuspecting will go forth believing that Obama is providing them hope and change!

Pallbearers will soon be the next change agents unless we stop this current rush to reform, bury it and start over.

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