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Annas writes that "[[Ivan Illich]] seems to have gotten it right in his 1975 ''Medical Nemesis'': 'Socially approved death happens when man [sic] becomes useless not only as a producer but as a consumer. It is at this point that [the patient] ... must be written off as a total loss. Death has become the ultimate form of consumer resistance'".<ref name=Annas/>
Annas writes that "[[Ivan Illich]] seems to have gotten it right in his 1975 ''Medical Nemesis'': 'Socially approved death happens when man [sic] becomes useless not only as a producer but as a consumer. It is at this point that [the patient] ... must be written off as a total loss. Death has become the ultimate form of consumer resistance'".<ref name=Annas/>


In a discussion on political lies between Paul Waldman of ''[[The American Prospect]]'' and [[Brooke Gladstone]] on the [[NPR]] show ''[[On the Media]]''—which contrasted between policy lies and personal lies—Waldman stated that {{cquote|Perhaps the lies about policy are the ones that are more consequential. For instance, in the health care debate that just happened, Sarah Palin came out and said that the [[Affordable Care Act]] included a provision for death panels that might condemn her disabled child to death. Now, that was a lie, and it was an extremely pernicious one that had definite effects.
A discussion on political lies between Paul Waldman of ''[[The American Prospect]]'' and [[Brooke Gladstone]] on the [[NPR]] show ''[[On the Media]]''—which contrasted between policy lies and personal lies—used the death panels claim as an example.<ref name=PoliticalLies/> Waldman proposed that personal lies lead people to question a person's moral characther while policy lies do not, despite the possibility policy lies might have more real world effects.<ref name=PoliticalLies/>{{cite episode |title=Political Lies and the Press |series=[[On the Media]] |network=[[NPR]] |station=[[WNYC]] |airdate=15 October 2010 |url=http://www.onthemedia.org/transcripts/2010/10/15/03}}</ref>

The provision in question, which did nothing of the sort but actually could have been valuable in helping people plan end-of-life care, that provision got removed from the bill amid all the controversy, and that whole death panel argument almost brought down the whole bill.

But what we didn't see was a big discussion about, well, you know, if Sarah Palin lied about that what other kinds of lies would she tell? Those sort of questions don't really get asked. When you tell a lie about policy, the discussion tends to revolve around what you did. Was that over the line? When you lie about a personal matter about yourself, the question that gets asked is not what did he do, but who is he?<ref>{{cite episode |title=Political Lies and the Press |series=[[On the Media]] |network=[[NPR]] |station=[[WNYC]] |airdate=15 October 2010 |url=http://www.onthemedia.org/transcripts/2010/10/15/03}}</ref>}}


===Politicians===
===Politicians===

Revision as of 15:48, 3 December 2010

Palin's claim played a key role in popularizing the term[1]

"Death panels" is a political term coined by former Republican Governor of Alaska Sarah Palin. It refers to a theoretical government-empowered panel of bureaucrats who are authorized to withhold life-saving medical treatment from patients.

Palin coined the term in 2009 on her Facebook page in reference to the US health care reform legislation sponsored by congressional Democrats and supported by President Barack Obama. Palin, who ran against the Obama ticket in 2008 as the Republican vice-presidential nominee, suggested that the health care bill contained a provision that would empower such a panel.

Although there was no such provision in the bill,[2] "death panels" quickly gained popularity as a political term among opponents of the legislation.

Palin's invention of the term and suggestion that "death panels" were part of the health care legislation has drawn heavy criticism. Republican Senator Johnny Isakson, who co-sponsored the 2007 Medicare End-of-Life Planning Act, called Palin's interpretation "nuts".[2] Politifact.com called Palin's suggestion 2009's "Lie of the Year",[3] and the term "death panels" was named the "Most Outrageous" term of 2009 by the American Dialect Society, who defined it as "[a] supposed committee of doctors and/or bureaucrats who would decide which patients were allowed to receive treatment, ostensibly leaving the rest to die."[4]

Background

Betsy McCaughey

In November 2008, following the United States presidential election, The Washington Times published an editorial[5] comparing the incoming Obama administration's potential policies to the forced-euthanasia programs pursued by Nazi Germany, specifically Action T4.[6] The Washington Times had previously endorsed the John McCain–Sarah Palin 2008 presidential ticket[7] and was described by the Orlando Sentinel as "an outlet decidedly opposed to Obama".[6]

Betsy McCaughey, who became prominent within the conservative movement with her critique of the 1994 Clinton health care plan,[8][9] began the false claim that the bill directed seniors to "end their life sooner",[1] and "got the ball rolling on ex-Sen. Fred Thompson's radio show on 16 July, when she called the bill 'a vicious assault on elderly people' that will 'cut your life short'".[10] McCaughey also falsely claimed that "the presidential health adviser Dr. Ezekiel J. Emanuel believed 'medical care should be reserved for the nondisabled'", which helped inspire Palin.[11] McCaughey was joined in spreading the idea by other pundits and conservative media outlets such as the editorial board of The Washington Times and The American Spectator magazine—outlets that helped defeat the 1994 plan.[8]

Provision

See also: End-of-life care

The provision, H.R. 3200 section 1233, that was targeted was written by Rep. Earl Blumenauer (D-OR) to allow "Medicare to pay doctors for voluntary counseling sessions that deal with end-of-life issues. The conversations between doctor and patient would include living wills, making a close relative or a trusted friend a health-care proxy, learning about hospice as an option for the terminally ill, and information about pain medications for people suffering chronic discomfort. The sessions would be covered every five years, more frequently if someone is gravely ill".[12]

Coining

On 7 August, Palin coined the term on her Facebook page[13][14] by stating

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil.[1][15]

When queried as to where in the proposed legislation[16] Palin thought "death panels" existed, her spokesman pointed to H.R. 3200 Advance Care Planning Consultation page 425.[17][18] An Institute for Southern Studies article speculates Palin was inspired by 29 July talking points released by the conservative Christian group Liberty Counsel.[18][19]

James A. Morone writes in Health Affairs that the term originated while Democrats focused on congressional negotiations.[20]

Use

George J. Annas writes that "[m]ake believe 'death panels' that would 'pull the plug on grandma' were used as a rhetorical device to block any rational discussion of either death generally, or end of life care in particular".[21] Paul Kettl, MD, MHA, writes that it was "a phrase that caught attention and served as a lightning rod for objections to a series of ideas about health care besides" end of life discussions.[22] The term became a standard slogan among many conservatives opposed to the Obama administration’s health care overhaul.[13] In August 2009, while Congress was in recess, it was used as an "outrageous allegation" to confront politicians at town hall meetings.[23] Dr. Brent J. Pawlecki, the corporate Medical Director for Pitney Bowes Inc.,[24] writes in Health Affairs that the term, along with "killing Grandma" was "used to fuel the flames of fear and opposition".[25]

Responses

Physicians

In response to the claim, David Casarett, MD, MA, associate professor of medicine at the University of Pennsylvania and Medical Director at the VA Hospital in Philadelphia,[26] was "mystified".[27] He said,

I really can't begin to figure out where this language is coming from. It bears really no resemblance to what's in the provision of the health-care reform bill. What's in the health-care reform bill is in general, text that I think most Americans and certainly all of my patients would support. The text of the bill really talks about giving patients and families the information they need to make the right choices. It's about giving patients an idea of what their options are. And it's giving patients and families a chance to talk about these things. So patients, families and physicians are all on the same page. Really, these sorts of discussions are about autonomy. They're about freedom. They're about independence. They're about having a say in your own health care. They're about values that are about as American as anything else I can think of. And so, to see this debate framing it in terms of some of the terms you mentioned before—death panels and euthanasia—is really both odd and frankly, startling to me that it's gone that far.[27]

Geriatric psychiatrist Paul Kettl, MD, MHA, authored an opinion piece in JAMA: The Journal of the American Medical Association entitled "One Vote for Death Panels", and begins his article by explaining he is not "in favor of some appointed group of erudite experts gathering to decide who lives or dies in a process controlled by the government, but rather the death panels that were originally proposed. I’m in favor of periodic discussions about advance directives that Medicare would pay for as medical visits."[22]

Writing in the New England Journal of Medicine, in an article entitled "Ending end-of-life phobia—a prescription for enlightened health care reform", Benjamin W. Corn, MD, saw that "the summer’s controversy over 'death panels' provided fodder for late-night comedians, but just under the surface of the joking there was evidence of" unease with end-of-life discussions.[14]

Atul Gawande, MD, "just thought it was kind of ridiculous. I knew it was an exaggeration, but this is politics, and some of that is bound to happen".[28]

Others

Annas writes that "Ivan Illich seems to have gotten it right in his 1975 Medical Nemesis: 'Socially approved death happens when man [sic] becomes useless not only as a producer but as a consumer. It is at this point that [the patient] ... must be written off as a total loss. Death has become the ultimate form of consumer resistance'".[21]

A discussion on political lies between Paul Waldman of The American Prospect and Brooke Gladstone on the NPR show On the Media—which contrasted between policy lies and personal lies—used the death panels claim as an example.[29] Waldman proposed that personal lies lead people to question a person's moral characther while policy lies do not, despite the possibility policy lies might have more real world effects.[29]"Political Lies and the Press". On the Media. 15 October 2010. NPR. WNYC.</ref>

Politicians

U.S. Senator Lisa Murkowski (R-AK) "told an Anchorage crowd that critics of health care reform, the summer's hottest political topic, aren't helping the debate by throwing out highly charged assertions not based in fact. 'It does us no good to incite fear in people by saying that there's these end-of-life provisions, these death panels,' Murkowski ... said. 'Quite honestly, I'm so offended at that terminology because it absolutely isn't (in the bill). There is no reason to gin up fear in the American public by saying things that are not included in the bill'".[30]

U.S. Senator Johnny Isakson (R-GA) "termed Palin's interpretation 'nuts'".[2] Isakson is an advocate for end of life consultation and "co-sponsored 2007's Medicare End-of-Life Planning Act and proposed an amendment similar to the House bill's Section 1233 during the Senate HELP Committee's mark-up of its health care bill".[2]

In an NPR segment entitled "The Politics Of Anger", Rep. Bob Inglis (R-SC), who had been the target of political anger, was asked if he thought it was wise for the opposition Republican Party to adopt ideas from the Tea Party. Inglis replied that "I think it's never a good strategy to travel on misinformation. Talking about death panels when there are no death panels is a disservice to the country and, long-term, to the conservative movement."[31]

Sarah Palin

In an interview with Barbara Walters, Palin acknowledged that none of the health care bills included the actual word pair; "No, death panel isn't there."[32] In November 2009, Palin said that "[t]he term I used to describe the panel making these decisions should not be taken literally."[33] Palin, in an Newsmax interview published online in October 2010 said she "was about laughed out of town for bringing to light what I call death panels ... I called it like I saw it, and people didn't like it".[34] Palin defended using the term.[34]

Impact

Atul Gawande, MD, writes in The New Yorker that the Affordable Care Act "was to have added Medicare coverage for [end of life] conversations, until it was deemed funding for 'death panels' and stripped out of the legislation".[35]

Morone says that the term played a role in Democrats losing control of the public debate. "The right-wing populists, selfstyled Tea Party activists, roared into the health policy discussion with fury over supposed 'government death panels.' The claims—a variation on the old cry of 'socialized medicine'—were pungent, memorable, simple, and effective", writes Morone.[20] Nyhan writes that "opponents of reform became inflamed by the claim".[1]

In response to the charges, Morone writes that "[a]s in the days of Truman and Clinton, the Democrats tried to deny charges, bypassing the underlying fears of big government and focusing on the facts. They pointed out that the proposed reforms didn’t constitute a government takeover of the health system".[20] "The administration also was seemingly unprepared for the intense opposition and fury that erupted during town-hall meetings in the summer of 2009. The Democrats' focus group–tested mantra of 'quality, affordable health care' was drowned out by Republicans' false warnings of 'death panels' and a 'government takeover'",[36] writes Johnathan Oberlander, a professor of Social Medicine and Health Policy & Management at the University of North Carolina-Chapel Hill.[37] Meanwhile, the White House was not able to offer a "persuasive narrative to counter the Tea Party percussion", and "struggled to recapture public attention", contributing to Scott Brown's election, writes Morone.[20] A TIME article wrote that "a single phrase—'death panels'—nearly derailed health care reform".[38]

By mid-August 2009, the Pew Research Center reported that 86% of Americans had heard of the 'death panels' claim.[1] Out of those who had heard the claim, 30% of people thought it was true while 20% did not know.[1] For Republicans, 47% thought it was true while 23% did not know.[1] In September 2010, six months after the passage of the Affordable Care Act, a BBC article stated that among the "sticky charges" that had stuck against the bill was the false charge of "government 'death panels' deciding who can get what sort of care".[39]

Lie and word of the year

PolitiFact.com gave Palin's term its highest rating—"Pants on Fire!"—on 10 August[40] and on 19 December it was named "Lie of the Year".[3][41][42] Bill Adair, editor of PolitiFact.com, stated that the runner up was Glenn Beck "for a claim about John Holdren, who was the White House science adviser. And Beck had claimed that Holdren in the past had proposed forced abortion and putting sterilants in the water".[42]

"Death panel" was named the most outrageous word of 2009 by the American Dialect Society.[43] The definition was given as "A supposed committee of doctors and/or bureaucrats who would decide which patients were allowed to receive treatment, ostensibly leaving the rest to die".[4] The nominees for 2009 included teabagger, sexting, and underpants bomber.[43]

Continued use

In December 2009, Palin compared being in front of journalists in Washington D.C. to a death panel for her, and she joked about her "reputation for foreign policy naivety".[44]

In September 2010, Palin reused the term in a strongly worded Facebook posting.[45]

In October 2010, The Philadelphia Inquirer highlighted the term in its "The Week in Words" article[46] after Barney Frank said the only death panels created by congressional Democrats were for troubled financial institutions under the authority of the Dodd–Frank Bill.[47] In the same month, Palin defended using the term in its original context.[34]

In November 2010, Paul Krugman used the term on This Week, and later opined about his comments.[48]

See also

References

  1. ^ a b c d e f g Brendan Nyhan (2010). "Why the "Death Panel" Myth Wouldn't Die: Misinformation in the Health Care Reform Debate" (PDF). The Forum. 8 (1). Berkeley Electronic Press. doi:10.2202/1540-8884.1354.
  2. ^ a b c d Ezra Klein (10 August 2009). "Is the Government Going to Euthanize your Grandmother? An Interview With Sen. Johnny Isakson". The Washington Post. Retrieved 12 November 2010.
  3. ^ a b "PolitiFact's Lie of the Year: 'Death panels'". Politifact.com. 19 December 2009. Retrieved 19 November 2010.
  4. ^ a b "'Tweet' 2009 Word of the Year, 'Google' Word of the Decade, as voted by American Dialect Society" (PDF). American Dialect Society. 8 January 2010. Retrieved 8 October 2010.
  5. ^ "No 'final solution,' but a way forward". The Washington Times. 23 November 2008. p. B.2.
  6. ^ a b "E-mails debunk 'death panels'". Orlando Sentinel. 14 August 2009. p. A.1.
  7. ^ "EDITORIAL: McCain for president". The Washington Times. 28 October 2008.
  8. ^ a b Jim Rutenberg and Jackie Calmes (13 August 2010). "False 'Death Panel' Rumor Has Some Familiar Roots". The New York Times.
  9. ^ Dwyer, Jim (25 August 2009). "Distortions on Health Bill, Homegrown". The New York Times. Retrieved 21 November 2010.
  10. ^ David Saltonstall (13 August 2009). "Ex-pol goes for the jugular. Former Lt. Gov. McCaughey leads 'death panel' charge". New York Daily News. p. 5.
  11. ^ Jim Rutenberg (4 September 2009). "Resurfacing, a Critic Stirs Up Debate Over Health Care". The New York Times.
  12. ^ Kim Underwood, Richard Craver (13 August 2009). "Seeing through the myths of a health-care overhaul". Winston-Salem Journal. Associated Press. p. A.1.
  13. ^ a b Mark Leibovich (12 September 2010). "The Wish for a Conservative Dream Duo". The New York Times.
  14. ^ a b Corn BW (2009). "Ending end-of-life phobia — a prescription for enlightened health care reform". N. Engl. J. Med. 361 (27): e63. doi:10.1056/NEJMp0909740. PMID 20018960. {{cite journal}}: Unknown parameter |month= ignored (help)
  15. ^ "Death panel, end-of-life become hot topics in U.S. health care reform debate". Xinhua News Agency. 13 August 2009.
  16. ^ America's Affordable Health Choices Act of 2009 (PDF) Library of Congress Accessed 19 November 2010.
  17. ^ Tapper, Jake (7 August 2009). "Palin Paints Picture of 'Obama Death Panel' Giving Thumbs Down to Trig". abcnews.com. ABC News. Retrieved 21 November 2010. Asked specifically what the former governor was referring to when painting a picture of an Obama 'death panel' giving her parents or son Trig a thumbs up or down based on their productivity, Palin spokeswoman Meghan Stapleton responded in an email: 'From HR3200 p. 425 see "Advance Care Planning Consultation".'
  18. ^ a b Sue Sturgis (11 August 2009). "Far-right religious group behind 'death panels' myth linked to other health reform distortions". Facing South. Institute for Southern Studies. Retrieved 11 November 2010.
  19. ^ David R. Francis (27 October 2010). "'Obamacare' tackles health care costs. Will Congress?". Christian Science Monitor. Retrieved 11 November 2010.
  20. ^ a b c d James A. Morone (2010). "Presidents and health reform: from Franklin D. Roosevelt to Barack Obama". Health Aff (Millwood). 29 (6): 1096–100. doi:10.1377/hlthaff.2010.0420. PMID 20530336. {{cite journal}}: Unknown parameter |month= ignored (help)
  21. ^ a b George J. Annas (2010). Worst case bioethics: death, disaster, and public health. Oxford University Press. p. 14. ISBN 019539173X.
  22. ^ a b Kettl P (2010). "One Vote for Death Panels". JAMA. 303 (13): 1234–5. doi:10.1001/jama.2010.376. PMID 20371773. {{cite journal}}: Unknown parameter |month= ignored (help)
  23. ^ "United States: Friend or foe?; The politics of health reform". The Economist. 392 (8644): 24. 15 August 2009.
  24. ^ "Insight Forums: Dr. Brent J. Pawlecki". Retrieved 20 October 2010.
  25. ^ J. Brent Pawlecki (2010). "End of life: a workplace issue". Health Aff (Millwood). 29 (1): 141–6. doi:10.1377/hlthaff.2009.0481. PMID 20048373.
  26. ^ David Jonathan Casarett: Description of Bioethics Expertise University of Pennsylvania Center of Bioethics. Accessed 19 November 2010.
  27. ^ a b "Doctor On End-Of-Life Care". All Things Considered. 18 August 2009. NPR.
  28. ^ "Dr. Atul Gawande: Make End Of Life More Humane". Fresh Air. NPR. 29 July 2010. Retrieved 19 November 2010.
  29. ^ a b Cite error: The named reference PoliticalLies was invoked but never defined (see the help page).
  30. ^ Lisa Demer (12 August 2009). "Murkowski: Don't tell lies about health bill; Some things in the legislation are already bad enough, she says at civic center". Anchorage Daily News. p. A.1.
  31. ^ "The Politics Of Anger". NPR. 18 July 2010.
  32. ^ Goldberg, Alan B.; Thomson, Katie N. (16 November 2009). "Sarah Palin: I Want to Play a Major Role in National Politics, 'If People Will Have Me'". ABC News. Retrieved 20 December 2009.
  33. ^ Lowry, Rich (17 November 2009). "The Rogue, on the Record". National Review.
  34. ^ a b c Chris Good (12 October 2010). "Sarah Palin Is Back on the Death Panels". The Atlantic. Retrieved 21 November 2010.
  35. ^ Atul Gawande (2 August 2010). "Letting Go: What should medicine do when it can't save your life?". The New Yorker.
  36. ^ Jonathan Oberlander (2010). "Long time coming: why health reform finally passed". Health Aff (Millwood). 29 (6): 1112–6. doi:10.1377/hlthaff.2010.0447. PMID 20530339. {{cite journal}}: Unknown parameter |month= ignored (help)
  37. ^ "Jonathan Oberlander — Dept. of Social Medicine". University of North Carolina School of Medicine. Retrieved 4 November 2010.
  38. ^ Michael Scherer (4 March 2010). "The White House Scrambles to Tame the News Cyclone". TIME. Retrieved 21 November 2010.
  39. ^ Katie Connolly (22 September 2010). "Why healthcare reform has been a tough sell". BBC News. Retrieved 24 November 2010.
  40. ^ "Sarah Palin falsely claims Barack Obama runs a 'death panel'". PolitiFact.com. 10 August 2009. Retrieved 19 November 2010.
  41. ^ Susan Davis (22 December 2009). "Palin's 'Death Panels' Charge Named 'Lie of the Year'". The Wall Street Journal. Retrieved 5 August 2010.
  42. ^ a b "The Year In Lies". All Things Considered. NPR. 18 December 2009. Retrieved 19 November 2010.
  43. ^ a b Charles E. Carson (2010). "Among the new words". American Speech. 85 (3). American Dialect Society: 352–65. doi:10.1215/00031283-2010-020.
  44. ^ Andrew Clark (6 December 2009). "It's the way she tells them: Sarah Palin jokes with journalists". The Guardian. Retrieved 15 October 2010.
  45. ^ Juli Weiner (24 September 2010). "Words That Shaped the Week: 'Death Panels,' 'Pavement,' and 'G.S.A.O.O.C.S.A.I.T.'". Vanity Fair. Retrieved 21 October 2010.
  46. ^ "The Week in Words: Death panels; muddling along; happy to retire at 60". The Philadelphia Inquirer. 31 October 2010. Retrieved 4 November 2010.
  47. ^ Christopher Condon (25 October 2010). "Frank Says 'Death Panels' Await Failing Banks Under Law Bearing His Name". Bloomberg. Retrieved 4 November 2010.
  48. ^ Paul Krugman (17 November 2010). "Death Panels and Sales Taxes". The New York Times.

External links

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