Source Material Theater: HR 3200

In the fight against BS, I don’t think there’s any tool in the skeptical arsenal more important than source material. I’ve often seen scientific papers cited (or quote-mined, as the case may be) by someone pushing pseudoscience. It lends an air of credibility to their claims. When that happens, the most important thing to do is to follow up. Check citations, and you often find that the papers have nothing to do with the pseudoscientific claim, or prove the exact opposite. I think the pseudoscientists (and other purveyors of BS) often count on the unwillingness of their victims to follow up and check the sources themselves.

Fun tip: When someone makes a claim to you in a verbal argument, don’t be shy about asking them what their source is. Oft times, they won’t have one, or will promise to get back to you and beat a hasty retreat. I do this often, and it always gives me a mean little thrill. There have only been a few occasions when someone’s “gotten back to me,” and it’s always turned out to be misread scientific research or bizarre religious or conspiracy theory websites.

A good example of the importance of source material is brought to us by the current health care reform mess.

DISCLAIMER: I am not going to try to convince you one way or another on the general issue. I personally think healthcare reform is necessary, but I also think we can all benefit from a well-reasoned debate. That involves, you know, facts. And stuff.

On my personal blog, I often post letters that I’ve written to my senators or other politicians. When I posted the letters I wrote to my senators about health care reform, on of my friends claimed that if the current bill (HR 3200) passes, senior citizens will be required to consult with a doctor every five years and be told about euthanasia and encouraged to use it.

My immediate response was a resounding, “Bzuh?” Considering that euthanasia is illegal in every state but Oregon, little alarm bells went off in my head. I thought it was best to check up on it, since it just seemed so utterly bizarre.

Now, this claim is making the rounds in a lot of places. This was a couple of weeks ago, however, so I had to do some creative googling to find exactly where this claim was coming from. I eventually found a blog post that cited section 1233 of the bill, which is about “Advance Care Planning Consultation.”

In all its brain-eating glory, here’s the important part of that section:

‘(hhh)(1) Subject to paragraphs (3) and (4), the term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years. Such consultation shall include the following:

‘(A) An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to.

‘(B) An explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.

‘(C) An explanation by the practitioner of the role and responsibilities of a health care proxy.

‘(D) The provision by the practitioner of a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organizations (including those funded through the Older Americans Act of 1965).

‘(E) An explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title.

‘(F)(i) Subject to clause (ii), an explanation of orders regarding life sustaining treatment or similar orders, which shall include–
‘(I) the reasons why the development of such an order is beneficial to the individual and the individual’s family and the reasons why such an order should be updated periodically as the health of the individual changes;
‘(II) the information needed for an individual or legal surrogate to make informed decisions regarding the completion of such an order; and
‘(III) the identification of resources that an individual may use to determine the requirements of the State in which such individual resides so that the treatment wishes of that individual will be carried out if the individual is unable to communicate those wishes, including requirements regarding the designation of a surrogate decisionmaker (also known as a health care proxy).
‘(ii) The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State–
‘(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; and
‘(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).
‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that–
‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;
‘(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;
‘(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; and
‘(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.

It’s rough to read. But the basic gist is that the government will pay for a consultation every five years, where people can discuss with a medical professional what kind of legal options they have for things like living wills, medical power of attorney, and hospice care. It doesn’t say that people can only talk about those things then, only that the government will only pay for it every five years. And most importantly, the end of life care options are governed by state laws, which means the only place you could possibly hear about euthanasia as an option is Oregon.

To get on my soap box for a moment, I think that this is fantastic. At the beginning of the year, my grandmother suffered a stroke that ultimately took her life. It was a rough time for our family. But because she’d gotten a living will done and taken care of all of the things the aforementioned consultation would provide for, we knew what she wanted and how we had to deal with things. We were able to make sure she was treated the way she would want to be, and it also took a lot of pressure off of my uncles and my dad, who were already dealing with the emotional issue of losing their mother.

So basically, once you look at the source of the claim, the claim falls apart. There’s nothing in the bill that says we’re going to force elderly Americans to consult with their doctors about euthanasia. There’s nothing that even says that they have to consult with a doctor about living wills. Rather, reading through it shows that it’s an offered service, a bonus if you will, so that people can at least chat about these things with their doctors every five years on the government dime.

If something sets of your mental warning bells, the first place to check is the supposed source of the claim, and often that will be enough to frame the claim for what it is. Now, sometimes it’s tricky to find the source, or the source itself turns out to be laughable and ludicrous. There are even times when the source is such that you can’t understand it because of language or educational barriers. But I’d say nine times out of ten, reading the source material is more than worth the effort of tracking it down and slogging through.

I sincerely wish that more people would check sources first before passing on strange claims. In this particular case, there are so many more important and worthwhile debates we could be having about this issue. We don’t need fear-mongering noise that has no basis in reality to drown that discussion out.

Perhaps, however, we can use this as a fine example of the importance of skepticism in everyday life.

Related: False Euthanasia Claims
Respectful Insolence: The Latest “Obama=Hitler” Shenanigans

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