Death Panel Dead (In the Senate Bill ONLY)

Hacker wrote:The Senate hasnt passed or rejected anything... they are on recess until the end of August. How Sarah (Wailin') Palin came up with the idea the Senate killed it is just incorrect.

Senators, who are working on their August vacation, have dropped the end-of-life legislation from the Senate version of the health care bill.Senator Charles Grassley (R-IA) says the end-of-life text has been dropped because "it could be misinterpreted or implemented incorrectly." Uh huh!

In a statement, Grassley criticized the House bill, saying there was a difference between a "simple education campaign, as some advocates want," and paying "physicians to advise patients about end-of-life care."

ohio county wrote:So, to reiterate yet once again, Palin claimed the "death panel" would deny care to her son, the President denied the legislation contained langauge that would include a "death panel", and in the interim the Senate committee has deleted the language authorizing the "death panel". Again, for a private citizen to make an assertion and cause the United States Senate to take action to address her concerns is unprecendented. What part of this is inaccurate?

ohio county wrote:So, to reiterate yet once again, Palin claimed the "death panel" would deny care to her son, the President denied the legislation contained langauge that would include a "death panel", and in the interim the Senate committee has deleted the language authorizing the "death panel". Again, for a private citizen to make an assertion and cause the United States Senate to take action to address her concerns is unprecendented. What part of this is inaccurate?

The choice is the patient's, regardless of politics.

Hacker wrote:http://www.nrlc.org/news/1999/NRL599/kevliz.html
Kevorkian Serving 10- to 25-Year Murder Sentence

Remember Dr. Death?
He tried to make euthanasia legal?

How can anyone possibly believe there will be a death panel?
Beyond anyone's wild imagination....

With the rapid advances in modern medicine, most people accept that no publicly funded healthcare system, including the NHS, can possibly pay for every new medical treatment which becomes available. The enormous costs involved mean that choices have to be made.

It makes sense to focus on treatments that improve the quality and/or length of someone’s life and, at the same time, are an effective use of NHS resources.

NICE takes all these factors into account when it carries out its technology appraisals (TAs) on new drugs. Our expert review groups (comprising both health professionals and patients) examine independently-verified evidence on how well a drug works and whether it provides good value for money.

To ensure our judgements are fair, we use a standard and internationally recognised method to compare different drugs and measure their clinical effectiveness: the quality-adjusted life years measurement (the ‘QALY’).

How is this calculated?
Although one treatment might help someone live longer, it might also have serious side effects. (For example, it might make them feel sick, put them at risk of other illnesses or leave them permanently disabled.) Another treatment might not help someone to live as long, but it may improve their quality of life while they are alive (for example, by reducing their pain or disability).

The QALY method helps us measure these factors so that we can compare different treatments for the same and different conditions. A QALY gives an idea of how many extra months or years of life of a reasonable quality a person might gain as a result of treatment (particularly important when considering treatments for chronic conditions).

A number of factors are considered when measuring someone’s quality of life, in terms of their health. They include, for example, the level of pain the person is in, their mobility and their general mood. The quality of life rating can range from negative values below 0 (worst possible health) to 1 (the best possible health). (See the box below for an example of how this works in practice.)

What about cost effectiveness?
Having used the QALY measurement to compare how much someone’s life can be extended and improved, we then consider cost effectiveness – that is, how much the drug or treatment costs per QALY. This is the cost of using the drugs to provide a year of the best quality of life available - it could be one person receiving one QALY, but is more likely to be a number of people receiving a proportion of a QALY – for example 20 people receiving 0.05 of a QALY.

Cost effectiveness is expressed as ‘£ per QALY’.

Each drug is considered on a case-by-case basis. Generally, however, if a treatment costs more than £20,000-30,000 per QALY, then it would not be considered cost effective.

How a QALY is calculated
Patient x has a serious, life-threatening condition.

If he continues receiving standard treatment he will live for 1 year and his quality of life will be 0.4 (0 or below = worst possible health, 1= best possible health)
If he receives the new drug he will live for 1 year 3 months (1.25 years), with a quality of life of 0.6.
The new treatment is compared with standard care in terms of the QALYs gained:

Standard treatment: 1 (year’s extra life) x 0.4 = 0.4 QALY
New treatment: 1.25 (1 year, 3 months extra life) x 0.6 = 0.75 QALY
Therefore, the new treatment leads to 0.35 additional QALYs (that is: 0.75 –0.4 QALY = 0.35 QALYs).

The cost of the new drug is assumed to be £10,000, standard treatment costs £3000.
The difference in treatment costs (£7000) is divided by the QALYs gained (0.35) to calculate the cost per QALY. So the new treatment would cost £20,000 per QALY.

A GP arrested last week for helping patients travel to Switzerland to die said yesterday that a landmark ruling on assisted suicide may make the situation more difficult for the terminally ill.


In the ruling, Debbie Purdy, who is suffering from multiple sclerosis, last week won the right to have the law on assisted suicide clarified by the law lords. As a result, the Director of Public Prosecutions (DPP) must state when prosecutions would be launched against those who accompany people abroad to take their own lives.

Ms Purdy wants her husband, Omar Puente, to be able to accompany her to a clinic in Switzerland without fear of arrest, when she chooses to die.

But Dr Michael Irwin, who has accompanied several terminally ill people to die at the Dignitas clinic in Zurich, said last night that he fears her case will in fact make it more difficult for relatives to travel with patients. Dr Irwin, who is on police bail for helping to fund a patient's death at Dignitas, said that a formal explanation of the law "could open a can of worms".

At least 115 Britons have killed themselves at Dignitas, often accompanied by relatives who risk up to 14 years in prison by travelling with them. Last week the law lords told the DPP, Keir Starmer, to clarify how his department decides whether or not to prosecute in assisted suicide cases. Dr Irwin fears that this clarification – which will appear as guidelines in September, before a consultation – will actually make relatives more vulnerable to prosecution.

"I've been concerned about the Debbie Purdy case from the start", he said. "It may make it more difficult for people because she's asking to have the [DPP] to come out publicly and say what friends and family might face.

"It all depends on the guidelines the DPP sets out in September, but he's boxed into a corner by the law lords now. Starmer himself mentioned financial gain as a consideration for guidelines and that could apply to a spouse or even grown-up children. You may have a situation where people have to rewrite a will to leave out a spouse so that they can't be prosecuted. It might have been a mistake to promote the Debbie Purdy case: it has drawn people's attention to the issue, which is good, but it could open a can of worms."

James Harris at Dignity in Dying, which has been promoting Mrs Purdy's case, said: "I don't share the concern. There may be aspects of the DPP's ruling that people want to question, but we'll have to wait until September. We think clarification is better than the current muddle where you have a blanket law which covers all assistance to suicide and isn't enforced."

Dr Irwin was arrested on Friday for giving 58-year-old terminal cancer patient Raymond Cutkelvin £1,500 towards the cost of his assisted suicide in 2007. The doctor had called on the police to arrest him a week after they arrested Mr Cutkelvin's partner of 28 years, Alan Cutkelvin Rees, 57, who also accompanied Mr Cutkelvin to the Dignitas clinic. Both men are on police bail until 23 September, but Dr Irwin says he intends to accompany another patient to the clinic in that time.