WSJ to Fox to CNN: Malveaux legitimizes “death book” distortions

Echoing distortions advanced by former Bush administration aide Jim Towey and Fox News Sunday host Chris Wallace, CNN White House correspondent Suzanne Malveaux introduced a report by correspondent Brian Todd by stating, “Are [military veterans] forced to face a variation of the so-called 'death panels,' as administration critics have called them?” In fact, as Todd's report indicated, the end-of-life educational booklet used by the Veterans Health Administration (VHA), which Towey has called a “Death Book,” does not encourage veterans to end their lives.

Contradicting CNN reporting, Malveaux asked if vets are “forced to face a variation of the so-called 'death panels' ”

From the August 24 edition of CNN's The Situation Room:

MALVEAUX: Military veterans are at the center of a new controversy in the debate over health care reform. Are they forced to face a variation of the so-called “death panels,” as administration critics have called them?

Our Brian Todd is here with the Situation Room investigation. And, Brian, what have you learned?

TODD: Well, Suzanne, this particular controversy focuses on a guide that's posted on the Department of Veterans Affairs website. The VA says this manual simply encourages vets to go over every possible scenario with their families, including what to do if they get too sick to make decisions themselves.

Todd's report did not mention “the debate over health care reform.” Despite Malveaux's assertion that the VHA manual is “a new controversy in the debate over health care reform,” in his report, Todd did not mention any of the health care reform plans or provide information suggesting that the VHA booklet has any bearing on the health care reform debate.

Malveaux falsely suggested “death panels” attack refers to something real, but CNN has repeatedly debunked the charge. CNN figures have repeatedly debunked right-wing claims that the House health care reform bill would encourage euthanasia of the elderly, including former Alaska Gov. Sarah Palin's (R) claim -- forwarded by the conservative media -- that the bill would create a “death panel” and the related claim -- initiated by former New York Lt. Gov. Betsy McCaughey (R) -- that the bill would “absolutely require” that seniors on Medicare undergo end-of-life counseling “that will tell them how to end their life sooner.”

Booklet does not “force” veterans to do anything. Todd reported that the “VA says this manual simply encourages vets to go over every possible scenario with their families, including what to do if they get too sick to make decisions themselves.” Nothing in Todd's report supported claims that veterans are forced to make certain decisions about end-of-life care.

CNN on-screen text refuted by report

CNN on-screen text: “Veterans' Guide to Dying: Are some being urged to end their lives?” Throughout the report, on-screen text asserted that the booklet is a “Veterans' guide to Dying”:

VA spokesperson: Booklet is “educational resource” to help individuals deal with health care questions. In his report, Todd stated that “a department official strongly denied that this guide suggests veterans end their lives when they're very sick,” and reported the official's statement that the guide is “simply an educational resource designed to help veterans deal with excruciating questions about what kind of health care they would like to receive.” Todd also reported: “The VA says this manual simply encourages vets to go over every possible scenario with their families, including what to do if they get too sick to make decisions themselves,” and aired a quote from bioethicist Paul Wolpe, the director of Emory University's Center for Ethics, who said the booklet “says, you might think you're being a burden when you're not a burden at all. Your family may want to reward your lifetime of love of them and relationship to them by taking care of you in your old age.”

“Your Life, Your Choices” emphasizes “your wishes will direct future health care decisions.” From the booklet, “Your Life, Your Choices: Planning for Future Medical Decisions: How to Prepare a Personalized Living Will”:

There's only one person who is truly qualified to tell health care providers how you feel about different kinds of health care issues -- and that's you. But, what if you get sick, or injured so severely that you can't communicate with your doctors or family members? Have you thought about what kinds of medical care you would want? Do your loved ones and health care providers know your wishes?

Many people assume that close family members automatically know what they want. But studies have shown that spouses guess wrong over half the time about what kinds of treatment their husbands or wives would want.

You can help assure that your wishes will direct future health care decisions through the process of advance care planning. [“Your Life, Your Choices,” Page 1]

“Your Life, Your Choices” asks individuals to consider the statement: “I believe that it is always wrong to withhold (not start) treatments that could keep me alive.” In a section that addresses “Personal and spiritual beliefs,” the booklet asks individuals to consider whether they agree with the following statements and to explain and clarify their beliefs regarding these statements:

I believe that it is always wrong to withhold (not start) treatments that could keep me alive.

I believe that it is always wrong to withdraw (stop) treatments that could keep me alive after they've been started.

I believe it is wrong to withhold (not provide) nutrition and fluids given through tubes, even if I am terminally ill or in a permanent coma. [“Your Life, Your Choices,” Page 22]

CNN on-screen text echoed Towey WSJ op-ed titled, “The Death Book for Veterans.” On August 18, The Wall Street Journal published an op-ed by Towey titled, “The Death Book for Veterans,” in which Towey criticized “Your Life, Your Choices,” asserting that “government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.”

Echoing Wallace and Towey, CNN report distorted passage that says: “If I'm a vegetable, pull the plug”

From the August 24 edition of The Situation Room:

TODD: Jim Towey, former head of the Bush administration's Office of Faith-Based Initiatives, is a harsh critic of a guide on the Department of Veterans Affairs website. It's called, “Your Life, Your Choices,” and counsels vets on how to plan their future medical decisions.

On one page, a fictitious character is quoted as saying, “I'd never want to live like a vegetable.”

Later, a questionnaire, “What makes your life worth living?” Its scenarios: being in a wheelchair, living in a nursing home, being a severe financial burden on my family. Vets filling it out are offered options to describe those situations from “difficult but acceptable” to “not worth living.”

“Your Life, Your Choices” passage addresses importance of being more specific regarding end-of-life care. In a passage explaining the importance of being very specific regarding end-of-life preferences, “Your Life, Your Choices” said that statements such as, “If I'm a vegetable, pull the plug,” can mean different things to different people. From the booklet:

Have you ever heard anyone say, “If I'm a vegetable, pull the plug”? What does this mean to you? What's a vegetable? What's a plug? Even people who live together can have very different ideas about what the same words mean without knowing it. The story of May and John Williams shows how important it is to be specific about what you mean.

“I'd never want to live like a vegetable.” Both May & John Williams have always shared this belief during their fifty years of marriage. But when they were talking about their advance care plans, they learned that they had very different views about what that meant. For May, it's when she can't take care of herself. John was surprised. For him, being a “vegetable” is much worse. “It's when my brain's not working but my body is being kept alive by machines.” [“Your Life, Your Choices,” Pages 6-7]

Towey misrepresented the passage in his WSJ op-ed. In his Wall Street Journal op-ed, Towey wrote of “Your Life, Your Choices”: “There is a section which provocatively asks, 'Have you ever heard anyone say, 'If I'm a vegetable, pull the plug'?' ” Towey never explained the context of the quote and suggested that the statement was “aimed at steering users toward predetermined conclusions, much like a political 'push poll.' ”

Wallace, Towey misrepresented the passage on Fox News Sunday. On August 23 on Fox News Sunday, Wallace similarly presented the “If I'm a vegetable, pull the plug” statement without context:

WALLACE: You're also upset about another question in the booklet, and I want to put that up: “Have you ever heard anyone say, 'If I'm a vegetable, pull the plug'?”

TOWEY: Yeah. I think the word vegetable's demeaning. It's used three times in the document, and it kind of communicates somebody that's not human. This is why I think the document is so fundamentally flawed that the VA ought to throw it out. [Fox Broadcasting Co.'s Fox News Sunday, 8/23/09]

Transcript

From the August 24 edition of CNN's The Situation Room:

MALVEAUX: Military veterans are at the center of a new controversy in the debate over health care reform. Are they forced to face a variation of the so-called “death panels,” as administration critics have called them?

Our Brian Todd is here with the Situation Room investigation. And, Brian, what have you learned?

TODD: Well, Suzanne, this particular controversy focuses on a guide that's posted on the Department of Veterans Affairs website. The VA says this manual simply encourages vets to go over every possible scenario with their families, including what to do if they get too sick to make decisions themselves.

Critics say it steers vets to question whether their lives are worth living.

[begin video clip]

TODD: They make up one of the most valued and vulnerable segments of America's population: millions of military veterans, some with debilitating injuries from recent wars, others facing health challenges associated with aging. Now, the agency charged with caring for them is accused of steering veterans toward ending their lives if they become too sick.

TOWEY: It guilt-trips veterans. It makes them feel like their life is a burden, not a gift.

TODD: Jim Towey, former head of the Bush administration's Office of Faith-Based Initiatives, is a harsh critic of a guide on the Department of Veterans Affairs website. It's called, “Your Life, Your Choices,” and counsels vets on how to plan their future medical decisions.

On one page, a fictitious character is quoted as saying, “I'd never want to live like a vegetable.”

Later, a questionnaire, “What makes your life worth living?” Its scenarios: being in a wheelchair, living in a nursing home, being a severe financial burden on my family. Vets filling it out are offered options to describe those situations from “difficult but acceptable” to “not worth living.”

TOWEY: Where is the column that says, “Yes, I have suffering in my life, but my life's beautiful. I find meaning and purpose, even though I have a disability”? ... When government only asks it in a build-up to life isn't worth living, I think it's wrong.

TODD: Contacted by CNN, the VA couldn't provide someone to speak on camera, but a department official strongly denied that this guide suggests veterans end their lives when they're very sick.

The official points out the guide is being revised, but issued a statement saying, “It's simply an educational resource designed to help veterans deal with excruciating questions about what kind of health care they would like to receive if they're unable to make decisions for themselves.”

And as one medical ethicist points out, the VA guide offers opposite scenarios as well.

WOLPE: It says, you might think you're being a burden when you're not a burden at all. Your family may want to reward your lifetime of love of them and relationship to them by taking care of you in your old age.

TODD: Paul Wolpe and the VA official we spoke with point out that the critic of the VA guide, Jim Towey, has his own manual on how to plan for future medical decisions if you're debilitated. And Towey charges for that.

[end video clip]

TODD: Now, when we asked Towey about that, he said his guide is not for profit and he's not pushing his manual over anyone else's. He says the difference here is that the VA guide is a taxpayer-funded document whose principal author is an advocate of assisted suicide.

Now, we checked on that. The lead author of the VA guide, Dr. Robert Perlman, did sign a brief supporting assisted suicide in a Supreme Court case many years ago. When we contacted Perlman, he said the VA had to speak for him on this issue. The VA official said Perlman's part in that Supreme Court case was not necessarily his personal view and that he was simply presenting some clinical findings in that case -- Suzanne.

MALVEAUX: So, is there a political angle to this controversy?

TODD: Well, Towey claims that this document was kind of suspended during the Bush administration for some of the problems that he said it presented. The VA said, no, that's not the case; this was actually -- this existed during the later years of the Bush administration and it crossed over into the Obama administration. So, they're denying a political bent to this.

MALVEAUX: OK, thank you very much, Brian.