THE TENSION: Wire: Obama Resuscitates VA 'Death Book' Directive

Off the Wire:

WASHINGTON, Aug. 21, 2009 -- In an article published on August 19, The Wall Street Journal discusses the ‘Your Life, Your Choices’ document that is given to veterans regarding their ‘end of life care.’

The article says last year, officials at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices."

The document was first published in 1997 and later promoted as the VA's preferred living will throughout its network of hospitals and nursing homes.

After the Bush White House examined how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, the article points out, under President Barack Obama, the VA has now resuscitated "Your Life, Your Choices."

This ‘end-of-life’ planning document is now being distributed to all Veterans receiving care:

"…a July 2009 VA directive instructs its primary care physicians to raise advance care planning with all VA patients and to refer them to "Your Life, Your Choices." Not just those of advanced age and debilitated condition—all patients. America's 24 million veterans deserve better."

Linked below is a copy of the ‘Your Life, Your Choices’ document.

Within the document exists a checklist that specifically asks questions about 'What makes your life worth living?'.

These questions are being asked to all Veterans receiving treatment, including 19 and 20 year-olds who have been severely wounded in Iraq or Afghanistan.

Listed below are all of the checklist questions:

a. I can no longer walk but get around in a wheelchair.
b. I can no longer get outside—I spend all day at home.
c. I can no longer contribute to my family's well being.
d. I am in severe pain most of the time.
e. I have severe discomfort most of the time (such as nausea, diarrhea, or shortness of breath).
f. I rely on a feeding tube to keep me alive.
g. I rely on a kidney dialysis machine to keep me alive.
h. I rely on a breathing machine to keep me alive.
i. I need someone to help take care of me all of time.
j. I can no longer control my bladder.
k. I can no longer control my bowels.
l. I live in a nursing home.
m. I can no longer think clearly-I am confused all the time.
n. I can no longer recognize family/friends
o. I can no longer talk and be understood by others.
p. My situation causes severe emotional burden for my family (such as feeling worried or stressed all the time).
q. I am a severe financial burden on my family.
r. I cannot seem to “shake the blues.”

These questions are followed by the questions below:

"If you checked "worth living, but just barely" for more than one factor, would a combination of these factors make your life "not worth living?" If so, which factors?

If you checked "not worth living," does this mean that you would rather die than be kept alive?

If you checked "can't answer now," what information or people do you need to help you decide?"