End-of-life counseling has been all the rage, sparking an emotional, nationwide debate. Never just the bridesmaid, the Department of Veterans Affairs is in this fray, too. Much has been made of the so-called “death book” for veterans. Pundits and lawmakers have taken aim, asking why the champion of veterans’ issues has been using “Your Life, Your Choices” to counsel vets on “planning for future medical decisions.”
It’s not the planning that’s the problem. The 53-page booklet seems to push one gently toward choosing death over medical care. We like the VA (including its secretary, Silent Eric), but this booklet would intimidate the most battle-scarred vet into a DNR and directions against any medical treatment.
“Your Life, Your Choices” opens with:
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. …
STOP. Now, why was Dad driving in the first place? It seems the kids knew the deal. The vignette makes no notice of that glaring fact.
The story continues:
… 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…
STOP. All of this is Dad’s fault? Message: Don’t be like Dad. Read the death book! Make sure you don’t make your family suffer because of your selfishness. Dad apparently had not seen the death book, otherwise, he would have made better choices. Don’t be a failure like he was. Make the right choice!
There is “helpful” information in the margins:
Go to “More information about health conditions and treatments” for greater detail. See page 29 for dementia, page 34 for feeding tube, page 28 for coma (and PVS), and page 35 for Ventilator.
And—
The percent of people with dementia increases with age. At age 65, it’s about 5 percent, at age 75, it’s 10-20 percent, and at age 85, it’s about 35 percent. …
The VA defends its use of “Your Life, Your Choices.” According to one spokesman, “The booklet is designed to help veterans deal with excruciating questions about what kind of health care they would like to receive if they are unable to make decisions for themselves.”
Excruciating? Excruciating if you use the booklet.
It is reasonable for the VA to help veterans put together some plan for these decisions, advanced directive or otherwise. (Call the lawyers.) But this book seems to subtly say, “You are selfish for wanting to live.”
“Your Life, Your Choices” may be anything but.