August 19, 2009

Depression, disability, and “being a financial burden” could constitute “Lebensunwertes Leben” (”Life Unworthy of Life”) in U.S. Government end of life planning document
by Bill Levinson

“The Death Book for Veterans: Ex-soldiers don’t need to be told they’re a burden to society” by Jim Towey in today’s (August 18) Wall Street Journal says,

Last year, bureaucrats at the VA’s National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, “Your Life, Your Choices.” It was first published in 1997 and later promoted as the VA’s preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated “Your Life, Your Choices.”

We downloaded this document directly from the Veterans Administration, and the content suggests that both family finances and depression–a non-terminal illness–could constitute Lebensunwerte Leben, or “life unworthy of life.” Smoke is generally indicative of fire and, although HR 3200 says nothing about mandatory end of life planning, euthanasia, or anything else similar to Germany’s Aktion T4 program–the euthanasia program that served as a precedent for the Holocaust–we have shown that there is indeed fire to go with the smoke. “Your Life, Your Choices” is simply more evidence, and it even suggests that war veterans with depression consider themselves a burden on the society that sent them to war.

Here is a screenshot of Page 21 of “Your Life, Your Choices,” downloaded directly from the Veterans Administration. As stated in the Wall Street Journal, this document was withdrawn when the Bush Administration saw content that could have come straight from Aktion T4, but the Obama Administration put it back into service. Note that it invites our veterans to define even non-terminal conditions (such as being in a wheelchair or having depression), to which few if any living wills apply, as “Lebensunwertes Leben.”

The following portion of the document also talks about money as a factor in defining “Lebensunwertes Leben.”

It is important to compare the content of “Your Life, Your Choices” to a normal living will such as that which is standard in Pennsylvania. The following says that treatment may be withheld or withdrawn only in the case of terminal illness or permanent unconsciousness (as opposed to depression, being in a wheelchair, or feeling that one is a financial burden on one’s family or society).

I, [insert name], being of sound mind, willfully and voluntarily make this declaration to be followed if I become incompetent. This declaration reflects my firm and settled commitment to refuse life-sustaining treatment under the circumstances indicated below.

I direct my attending physician to withhold or withdraw life-sustaining treatment that serves only to prolong the process of my dying, if I should be in a terminal condition or in a state of permanent unconsciousness.

I direct that treatment be limited to measures to keep me comfortable and to relieve pain, including any pain that might occur by withholding or withdrawing life-sustaining treatment.

In addition, if I am in the condition described above, I feel especially strong about the following forms of treatment:

I ( ) do ( ) do not want cardiac resuscitation.
I ( ) do ( ) do not want mechanical respiration.
I ( ) do ( ) do not want tube feeding or any other artificial or invasive form of nutrition (food) or hydration (water).
I ( ) do ( ) do not want blood or blood products.
I ( ) do ( ) do not want any form of surgery or invasive diagnostic tests.
I ( ) do ( ) do not want kidney dialysis.
I ( ) do ( ) do not want antibiotics.

I realize that if I do not specifically indicate my preference regarding any of the forms of treatment listed above, I may receive that form of treatment.

Other instructions:
I ( ) do ( ) do not want to designate another person as my surrogate to make medical treatment decisions for me if I should be incompetent and in a terminal condition or in a state of permanent unconsciousness. Name and address of surrogate (if applicable):

Name and address of substitute surrogate (if surrogate designated above is unable to serve):

I ( ) do ( ) do not want to make an anatomical gift of all or part of my body, subject to the following limitations, if any:

I made this declaration on the day of (month, year).

Declarant’s signature:
Declarant’s address:

The declarant or the person on behalf of and at the direction of the declarant knowingly and voluntarily signed this writing by signature or mark in my presence.

Witness’s signature:
Witness’s address:
Witness’s signature:
Witness’s address: