VA Is Right to Help You Consider End-of-Life Choices

I did not read Jim Towey's "The Death Book for Veterans" op-ed in the WSJ

http://online.wsj.com/article/SB20001424052970204683204574358590107981718.html

But these letters are perfect:

VA Is Right to Help You Consider End-of-Life Choices
WSJ 8/27/09


Reading Jim Towey's "The Death Book for Veterans" (op-ed, Aug. 19) made me seek out and read "Your Life, Your Choices" on the Department of Veterans Affairs (VA) Web site: http://www.ethics.va.gov/YLYC/YLYC_First_edition_20001001.pdf. I found it to be a common-sense, plainly written discussion of some very uncomfortable topics. It addresses many of my own fears and desires, and makes me ready to draw up my own wish list. I'm not scared of death, but I'm awfully frightened of dying. The last thing I want is to be kept alive when I've permanently moved beyond my definition of acceptable quality of life. The workbook helps you articulate and record your own wishes. In the real world people do worry about becoming a burden; why not address it? A living will written while you're healthy short-circuits the "slippery slope" concept. It's high time we confronted our collective denial about death and dying. While my father was dying of cancer my family read all of the Hemlock Society literature and were prepared to act. My father wanted to live and never availed himself of its methods, but it sure made him feel empowered to know that he had some element of control over the end of his life. If we save on health-care costs by making this material available, that's just a fortunate coincidence.

Jon Gersh
Arlington, Mass.

This veteran and oncology patient has never got the feeling from my various superb VA doctors and medical staff that I was a burden to anyone. Indeed, just the opposite. I have never heard of any such thing as "Your Life, Your Choices." I have, in fact, been asked by VA reception staff if I had a "living will," and if I had any "final directives" which I wanted to add to my files. I obtained these papers independently, and at a time of my choosing from a private lawyer of my choice, and the wording of those documents was approved by me, line by line.

Charles M. Griffith
Middletown, Md.

The VA's "do not resuscitate" policy is clear: Physicians are not obligated to provide "futile" treatment which they believe is contrary to good medical practice or simply "bad medical practice." However, in situations where the patient (or family) insists that treatment be provided, the wishes of the patient must be respected. The VA has not adopted or promoted efficiency at the expense of veterans' lives and health. The sweeping changes brought about by the new "Integrated Ethics Initiative," formally launched by the National Ethics Center in 2007, has not changed, reduced or chipped away the right of a veteran patient to make health-care decisions based on his values and preferences, for the sake of cost and efficiency. I have not seen VA physicians, nurses or social workers steering vulnerable soldiers returning from active duty in Iraq or Afghanistan to conclude that their lives are not worth living; nor have I changed the way I protect patients' rights, a method supported by 50 years of case law and engrained in American biomedical ethics. I have not seen anyone denying veteran patients the costly medical treatment they need for their care, nor have I seen hospital policy to this effect.

Evelyne Shuster, Ph.D.
Philadelphia

http://online.wsj.com/article/SB20001424052970204884404574365070562514310.html

Printed in The Wall Street Journal, page A14