THE REALITY BEHIND THE "DEATH PANELS."

There is a lot of confusion and fear being sown by health care reform opponents about end-of-life care, with terms "euthanasia" and "death panels" being thrown around willy-nilly. Ezra Klein does a good job clearing that up in this interview with Georgia Republican Senator Johnny Isakson, who happens to be a key legislator behind end-of-life provisions in congressional health care reform legislation. Isakson does a good job explaining what is actually going on:

In the health-care debate mark-up, one of the things I talked about was that the most money spent on anyone is spent usually in the last 60 days of life and that's because an individual is not in a capacity to make decisions for themselves. So rather than getting into a situation where the government makes those decisions, if everyone had an end-of-life directive or what we call in Georgia "durable power of attorney," you could instruct at a time of sound mind and body what you want to happen in an event where you were in difficult circumstances where you're unable to make those decisions.

This has been an issue for 35 years. All 50 states now have either durable powers of attorney or end-of-life directives and it's to protect children or a spouse from being put into a situation where they have to make a terrible decision as well as physicians from being put into a position where they have to practice defensive medicine because of the trial lawyers. It's just better for an individual to be able to clearly delineate what they want done in various sets of circumstances at the end of their life.

This makes a lot of sense. These are decisions that should be made by individuals about their own lives when they have the capacity to do so, and if that helps cut overall health care costs, so much the better. Imagining the kinds of situations where someone else, whether it is the government, your family or your physician, making these decisions for you, is certainly unsettling, and a clear mechanism for resolving these difficult questions would offer a lot of peace of mind. It's nice to hear a very conservative Republican make this useful point.

-- Tim Fernholz