Lies and the Lying Liars Who Tell Them

I borrow the title of Al Franken's book for this post because, as is usually the case when dealing with right-wing pundits, it is apt. This is inspired by Daily Show host Jon Stewart's exchange with lying liar Betsy McCaughey, who would like to reprise her fifteen minutes of fame by playing a critical role in sinking not one, but two health care reform packages in her lifetime. First, watch some of the exchange, via James Fallows (it's thirteen minutes total between the two segments so I forgive you for not watching the whole thing; you don't need to for the purposes of this post anyway.) Now, observe this excerpt from Fallows' post:

That is: when McCaughey admits that there is no literal "death panel" provision in the new health care provision, she goes on to say something similar to what other conservatives, most recently Charles Krauthammer in the Washington Post today, contend: that the very act of reimbursing doctors for a discussion about "living wills" and end-of-life care will have a subtle bias in favor of an euthanasia-like outcome.

On the merits of this claim, I vehemently disagree. Having had, along with my siblings, first-hand, extended, and very painful experience with this process during my own father's decline and death last year, I would put reimbursement schemes for living-will discussions at the very bottom of the list of factors that make such decisions so wrenching for everyone involved.

This is the article by lying liar Krauthammer that Fallows is referring to, wherein Krauthammer concludes that it is "obvious" that it's better to rely upon the wishes of family and friends then some "form" somebody checked off "some fine summer's day years before being stricken." Really? Terri Schiavo might beg to differ.

It is simply a lie to say that mere discussions about late stage health care and end-of-life decisions will influence people (subtly or otherwise) to die early against their will (or be "euthanized", which isn't even legal in any state in the nation.) I'm not even going to assume for the purposes of argument, like Fallows does, that there might be such an effect because there isn't. And it is a pernicious and malicious lie at that, because this lie-whose primary goal is to scare idiots and the uninformed into being afraid of health care reform-will also have the incidental effect of encouraging people to avoid not only getting medical powers of attorney or advanced directives (also known as "living wills") but to avoid even talking about how much treatment they want before they die. It would not surprise me in the least to find out that there are literally thousands of people who, thanks to the casual but malicious lying of people like Krauthammer and McCaughey, will now delay or avoid having discussions about end of life care with their doctors or their family members, for fear that they might be giving somebody permission to stick a needle in them and send them off to the great beyond earlier than they might like. So what will they get instead? They will get family members arguing over how "grandma" wants to die (and sometimes going to court about it, a la Schiavo) or if they are alone, they will have anonymous doctors or hospital administrators or courts make the decision for them. Some of them will die in agony, when had someone spent fifteen minutes talking to them about it, they might have decided to die another way. Perhaps even some will be disconnected from life support because their family "knows" it's how they want to die (and anyway, best to get to probating grandma's estate so they can get her china) when in fact that person would have preferred to hang on until even machines couldn't keep them alive.

Before this health care reform "debate" you couldn't find anyone but the perhaps the most conservative, pro-life Catholics who would be against medical powers of attorney, or advance directives, or even mere discussions with family members or doctors about end of life care. That's because everyone with any amount of intelligence and compassion would rather let the individual make decisions about their own end of life care, whether they do it by advising family members they trust on what to do, or grant someone else the authority to make decisions for them, or advise doctors in advance what they want done. This is especially the case with the legal community, as both lawyers and judges have seen quite directly the effects of a failure to plan for the end of life, and are routinely advising people to get documents that will assure that their wishes are carried out both as and after they die.

But thanks to lying liars like Krauthammer and McCaughey, progress on this front has probably been set back a good ten or twenty years, all because defeating health care reform justifies any lie, no matter how pernicious or no matter the effect it has on actual, real people. I'm not a Christian, and even if I was I doubt I'd believe in Hell. But if there is one, it is my most sincere and fondest wish that there is a special circle reserved for the likes of Krauthammer and McCaughey, and all those who lie without regard to the impact their lies have on the lives and deaths of real people.

UPDATE: Kevin Drum beat me to the punch:

Up until two minutes ago, politicians and pundits across the political spectrum universally believed that advance care counseling was an entirely sane and uncontroversial practice, one that any compassionate society would encourage. Those same politicians and pundits knew perfectly well that it was never about guiding patients in any particular direction and has never been motivated by cost savings in any way. They knew that other countries reimburse for advance care planning — just like any other use of a doctor's time — and it hasn't led to any pressure, subtle or otherwise, to pull the plug on grandma.

They knew this. Until two minutes ago. But now they're pretending — subtly, temperately — that maybe it isn't true after all. And they're doing this not because they've changed their minds, but because they want to kill healthcare reform for political reasons and they don't care whether innocent bystanders get hurt in the process. Their "Yes, but" campaign might ensure that patients forevermore mistrust doctors who talk about advance care directives, but they also know that sober, serious, subtle op-eds endorsing this point of view are more likely to derail healthcare reform among the chattering classes than Sarah Palin's Facebook maunderings. It is intellectual venality of the first order.

Still, scholars of Dante, which circle of hell is reserved for intellectual venality?