Universal Health Care Coverage

This column by Nat Hentoff has set off a lot of chattering. I think he's wrong to denigrate end-of-life planning and advance medical directives. I think his condemnation of a mythical regime in which an ultimate, life-deciding federal board "...decides whether your quality of life, regardless of your political party, merits government-controlled funds to keep you alive," is inaccurate and unethical.

Here's what I wrote on my shul's listserv today:

(A) Every competent, responsible adult should have

a valid, legal, living will, with clear instructions, and
a valid, legal, detailed advance medical directive.

If you have a good will, you’ve only tried to resolve matters that will come up after you’re dead. You haven’t touched stuff that’s, arguably, much more important.

A living will and an advance medical directive relieve, comfort and advise those you love when you are no longer able. These are excruciating decisions. Life is better if the person for whom decisions are being taken has made his or her wishes crystal clear, in advance.

(B) End-of-life concerns are being turned into a tactical, political “wedge issue,” raised not so much to bring light as to generate heat. It’s pretty loathesome.

The President’s health care reform efforts are big, broad ideas, worthy of debate and action. But most especially important is his effort to establish universal health care coverage. In my view, the absence of universal health care coverage in these United States is a shameful blemish on our record.

Let’s keep our eye on the ball.

(C) Nat Hentoff is the gold standard as a jazz music writer. The same goes double for his writings on the Bill of Rights, civil liberties and integration.

On medical ethics in the pre-natal and end-of-life contexts, not so much.