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Specter Prods VA On End-of-Life Advice

Sen. Arlen Specter (D-Pa.) said he has not read the decade-old VA publication
Sen. Arlen Specter (D-Pa.) said he has not read the decade-old VA publication "Your Life, Your Choices" but is disturbed by what critics have said about it. (By Tom Mihalek -- Associated Press)
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By Steve Vogel
Washington Post Staff Writer
Tuesday, August 25, 2009

Sen. Arlen Specter (D-Pa.) called on the Department of Veterans Affairs on Monday to consider suspending its use of an end-of-life planning document that critics have dubbed the "death book for veterans."

"There is an issue as to whether the VA document inappropriately pressures disabled veterans who forgo critical care by subtly urging them on end-of-life decisions," Specter wrote in a letter requesting that the Senate Veterans' Affairs Committee hold a hearing on the matter.

VA officials said that the document has been misrepresented by critics and that the decade-old publication, titled "Your Life, Your Choices," is an "educational resource" meant to help veterans direct in advance the medical care they want in the event they are incapacitated.

"Recently, some folks have been distorting the purpose of a Veterans Affairs planning tool called 'Your Life, Your Choices,' " VA spokeswoman Katie Roberts said. "The booklet is designed to help veterans deal with excruciating questions about what kind of health care they would like to receive if they are unable to make decisions for themselves."

The controversy stems from an opinion piece published last Tuesday in the Wall Street Journal and written by Jim Towey, who was director of the Bush White House's Office of Faith-Based Initiatives from 2002 to 2006.

The booklet, Towey noted, includes a worksheet titled "What makes your life worth living" that presents various scenarios, such as being confined to a wheelchair, relying on a feeding tube or being unable to "shake the blues."

Towey compared the wording of the worksheet to a political "push poll" meant to steer readers to a predetermined conclusion.

"This hurry-up-and-die message is clear and unconscionable," wrote Towey, who noted that the Bush administration had suspended use of the document but that it has been "resuscitated" by the Obama White House.

Towey repeated the charges in an appearance on "Fox News Sunday," which also featured appearances from Specter and Assistant Secretary of Veterans Affairs Tammy Duckworth, who is a wounded veteran of the Iraq war.

Specter said in an interview yesterday that he had not read the booklet but was disturbed by what he had gleaned thus far. "I heard an inference that people might be inappropriately influenced to withhold medical treatment," he said.

Specter's letter, which was also sent to VA Secretary Eric K. Shinseki, says that "consideration should be given to suspending it temporarily until a determination is made as to its appropriateness."

The document was developed under a federally funded research grant and published in 1997. It is not an advance directive or living will, Roberts said. It has been restored to the VA Web site because it was produced with federal money, she said.

The document is being revised, according to VA officials.

Towey, as he noted in his Wall Street Journal article, has written his own book on advance care planning.


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