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Kaiser Permanente's Duty to Die Ethic
 
    "The supposed empowerment of having patients sign advanced directives really only sets up an easy
slide to the Duty to Die goal.  The directives merely state that the patient does not want to be a prolonged
vegetable; unethical physicians will turn that into a Do Not Resuscitate statement.   Rogue hospice units will
accelerate that to a quick death by morphine.   Signers beware." 

Dr. Phillips

    As a rule living wills should be kept by the family and are only useful in helping the family get rid of
the guilt associated with letting a loved one die when there is absolutely no hope. 

..... the chances of an undesired premature death are increased. A lot of people thought the plug should be pulled on Christopher Reeves. - From a Doctor that wishes to not be identified.

    Some people may be willing to endure years of incommunicative agony in the hope they may recover. Others may not. Different rules would be required. -

Dr. Harvey Frey

    Now why would Kaiser do such an evil thing?  I want the reader to think about the pennies that Kaiser saves each time they do not provide a transplant, each time they do not help a diabetic and each time they do not provide any cancer treatment for a patient because "after all they have chronic long term problems that just keep eating up Kaiser funds."

    When a patient is denied a pap smear test because of cancerous symptoms within a year of already having this routine test, when a patient with a high fever and chills is denied treatment, or admission into the ER and later dies from West Nile or Meningitis they are being presented with the Kaiser Duty to Die business practice.

    When a senior citizen is denied medical care they are being told they are worthless eaters, that they are not worth spending the money on even though that senior and Medicare are paying to have medical treatment.

    When you are strongly encouraged or brow beaten into signing an advance directive, or more commonly referred to as a living will, which you have not participated in writing by your insurance company or hospital or doctor, be aware that some of these are not looking out for your best interests.  Be aware that sometimes they will determine that even though you have a long term chronic medical condition and could live for many more days, weeks, months or years that if a crisis occurs, either naturally or with a little unethical medical assistance you may not be revived for pure financial reasons.  The Kaiser HMO profits more by having you die rather than having you live in these type of cases unless they have a Federally Funded, or Pharmaceutically Funded testing program in place for which they are paid large sums of money to experiment on you with.

    These types of acts are not true negligence as this is an intentional act on the part of the insurance company of which the physician's personally profit and openly participate.  I believe these types of acts to be criminal in nature, though District Attorney's and police departments that rely on insurance company tax revenues to keep their doors open will mostly look the other way when a complaining member of the public tries to file a police report.  They profit off of this as well, for often their jobs will rely on having that tax revenue keep coming in. 

    Also regarding the story of there being facilities where comatose patients, the so called vegetables, are warehoused:  A mind picture is painted of row after row of these people in some kind of limbo just waiting for someone to pull the plugs appears not to be anything more than an urban legend.  We did some checking with physicians and not a single one of them had actually seen such a place, knew where to send someone in that shape to be warehoused nor even believed that they exist.  Stuff does happen, some people are in comas for years, some people are on life support when there is no real hope of survival - such as when their brain has basically been removed to put it bluntly - but they are few and far between. 

    If you do not have a Living Will or Power of Attorney for Medical matters then for most cases the physician will be forced to work with the entire family.  There are some physicians that do create what is called Iatrogenic Disease - a disease created by a medication or medical accident.  There are physicians that defraud the government by billing for diseases when all the patient really has is a medication side effect. They also will convince the patient and their families for purposes of financial fraud that the patient is seriously ill.  They are criminals and should be spending time in prison.  Those type of doctors can and will try to declare any patient that is over-medicated, with any side effects, incompetent with the purpose of gaining control of their assets and fraudulently billing Medicare.  A Living Will or Medical Power of Attorney may possibly help in that type of situation, but then again it may not. Make sure you family is aware of these type of physicians so whether you have a Medical Power of Attorney signed or not, someone knows what you want done. No document can protect people from the wrong diagnosis and its attenuated treatment. - Dr. Charles Phillips.

    While the public is blindly trusting that their money paid to their HMO is some sort of a bank account invested in their medical care for some unknown event in the future what it really is a really big bank account for the HMO that will go out of it's way to avoid providing care for the patient at all costs. 

    You will hear these business practices spoken of as for the "greater good of all."  As if this were war time and our resources on a whole were stretched so thin that people had to ration bread, sugar and gasoline. See: CONVENTION ON THE PREVENTION AND PUNISHMENT OF THE CRIME OF GENOCIDE 
See also U.S. Code Sec. 1091. - Genocide

    I think that most people when they pay hard earned money to an insurance company or when they pay money to their union so they can buy their insurance, that these thoughts don't even cross their minds.  I doubt that no one thinks of the greater good of all when they pay money for medical care at any time. What they are thinking of is getting well or not getting sick at all.  They think that when they need medical care it will be provided for them when they pay their insurance premiums.  They certainly don't expect to hear that they are not worth taking the time to provide care for and they never would think that they could be killed or encouraged to die if they dare to develop a disease or medical condition. 

    Unfortunately that is exactly what is happening and it is the patient's responsibility to realize this, acknowledge this and get over the fantasy that all doctors and hospitals are only there to provide tender, loving care to the patient and their family.  Those days are long over for the vast majority of people in the Kaiser HMO system as well as many others. - Vickie Travis

    The following is a sample Power of Attorney for Health Care.  It is better than the standard form that your HMO or hospital will try to coerce you into signing.  You do not have to use it as is.  You do not have to sign anything written as is by any physician's office, HMO or hospital either. You don't even need a living will as this is sometimes called.  You have the right to cross out anything you want and add anything that you want to.  There is no mandatory form put out by any branch of government that has to be used. There is no law that says you need have one of these on file. You don't even have to have one of these forms filled out and signed if that is your wish. Kaiser employees that have told patients that are wrong and should become educated in what they are speaking about.  There is no clause in your contract with Kaiser nor any other HMO that says you have to have one either.  If they ever start doing that then find another insurance company real fast!  If any employee pushes this on you suspect them of receiving a financial reward for obtaining your signature and wonder what motive your HMO would have in doing that.

    I do suggest that you consider inserting a statement if you opt any form to the effect that if unconscious for a week or month, whatever sounds good to you that the person in charge give you a chance to wake up before pulling any tubes. At least give them a time period before they would consider doing such a thing no matter what a stranger to them medical person would tell them to do. Hospitals wanting to make room for new patients often want to rush these types of things along.  

   Make sure that your designated person knows that they should give you some time to wake up and recover.  Make sure they realize that tubes to feed you do not necessarily mean anything other than you need some food and that is the best way to give it to you.  

    Make sure they understand that tubes to help you breathe don't necessarily mean anything other than they are helping you breathe.  That is not life support.  

    Make sure also that they understand that you have no wish to be starved to death nor have liquid withdrawn because you are unable to speak or feed yourself.  Medical personnel often want to rush a patient into a hospice situation to make room for new patients and make more money off of Medicare.  Don't fall prey to that scam by leaving explicit instructions. Be real clear that if you do end up with a tube somewhere that makes it so you cannot speak that you are not deaf nor are you brain damaged.  All it means is that you can't speak.  If some medical person says anything to the contrary then have your designated representative know that they should satisfy for themselves whether or not you truly are brain damaged and darn sure if it appears that way that you aren't just overmedicated. 

    Being overmedicated for the convenience of hospital staff does not mean you are incompetent as one doctor tried to convince my family regarding my father's state of being.

    Also you might want to mention that being ill could make you a cranky patient and that does not mean you are depressed or psychotic so don't allow the meds to be pushed on you if you really don't need them. Cranky does not mean depressed or nuts, it means you are sick or sick of being sick and nothing more.  

    Ativan every 2 to 4 hours is only going to make you sleep all the time, it will not help you get well or experience any form of life.  All it does it make you a person being warehoused. 

    One of the side effects of Ativan is muscle spasms, so if you are going to be on a lot of that stuff, know that you could actually end up in a great deal of pain.

    Encourage in this document that the person or persons designated do some investigative work themselves to fully understand and believe what they are being told about your medical condition.  

    Make sure they know not to believe any explanation that is put in childish, unrealistic terms, especially ones that do not make sense.  Do not cower to anyone under the banner of authority trying to force a signature for a DNR when it truly isn't necessary or wanted.  

    DNR often translates to someone creating a medical accident such as an overdose of morphine or potassium to do you in.  If that DNR is in place no one is going to try to save you and no one is going to investigate what happened either.  It is your business what you decide to do - not a hospital nor nurses nor a doctors business.

    I also suggest that in the event a Conservator is required that explicit instructions are in your document that no person employed or appointed by any form of government be allowed to oversee your medical care.  For the most part those type of people just don't care and you are only a number and paycheck to them.  The risk is too great that they will sell you out for a few bucks.  

    I look at it this way - If someone is going to rob me and my family blind then at least let it be done by a member of the family rather than a stranger. 

    Lastly, consider the burden on a sole member of the family bearing responsibility for your care.  No matter what the outcome they will have some form of guilt.  I suggest that you have two or more people, as a unit bear the responsibility equally. If that means involve the neighbors or a minister then do so but make sure that they are willing to participate if it comes to that.  If anything, they should be honored to even be considered if they are decent people.

    As mentioned before you do not need to include everything in the following document in your Power of Attorney for Health Care.  You can add anything that you want to in this document. You can also remove anything that you want to.  There is no law that says you even have to sign one of these documents if that is your wish.  
 
POWER OF ATTORNEY FOR HEALTH CARE

[Name]

      (1.1) DESIGNATION OF AGENT:  I designate the following individual as my agent to make health care 

decisions for me:

[name, address, phone] 

 If I revoke my agent's authority or if my agent is not willing, able, or reasonably available to make a health care 
decision for me, I designate as my alternate agent:
[name, address, phone]

      (1.2) AGENT'S AUTHORITY:  My agent is authorized to make all health care   decisions for me, 
including decisions to provide, withhold, or withdraw artificial nutrition and hydration and all other forms 
of health care to keep me alive, except as stated below. Agent is also hereby given signature authority over 
all my credit cards, bank accounts, and brokerage accounts for the purposes of paying any necessary bills 
during my period of incompetence.

     (1.3) WHEN AGENT'S AUTHORITY BECOMES EFFECTIVE:  My agent's
authority becomes effective when my responsible physician determines that I am unable to make my 
own health care decisions, and shall cease if I again become competent. 

     (1.4) AGENT'S OBLIGATION:  My agent shall make health care decisions for me in accordance 
with this power of attorney for health care, and my other wishes to the extent known to my agent. To the 
extent my wishes are unknown, my agent shall make health care decisions for me in accordance with 
what my agent determines to be in my best interest, considering my personal values to the extent known 
to my agent.
     (1.5) AGENT'S POSTDEATH AUTHORITY:  My agent is authorized to make
anatomical gifts, authorize an autopsy, and direct disposition of my remains.

     (1.6) NOMINATION OF CONSERVATOR:  If a conservator of my person needs to
be appointed for me by a court, I nominate the agent designated in this form.  If that agent is
not willing, able, or reasonably available to act as conservator, I nominate the alternate agents 
whom I have named, in the order designated.

INSTRUCTIONS FOR HEALTH CARE

       (2.1) END-OF-LIFE DECISIONS: 
 I do not want my life to be prolonged if any of the following are true:

(1) I have a painful, incurable and irreversible condition that will most likely result in my death within 
three (3) months, or 

     (2) I become unconscious and, to a reasonable degree of medical certainty, I will not regain consciousness, or

      (3) My brain has become so irreversibly damaged that I am effectively unaware of my surroundings, or

      (4) the likely pain, discomfort, or disability of treatment would outweigh the expected benefits. 

      (2.2) RELIEF FROM PAIN:  I direct that purely palliative medical, surgical or radiation treatment 
be provided, even if it hastens my death, UNLESS:

      (1) It will interfere with treatment of an acute, self-limited, or treatable condition, and

       (2) I have an otherwise comfortable life expectancy of six (6) months.

 Adequate doses of analgesics shall not be withheld for fear of addiction.

       (2.3) EXPERIMENTAL TREATMENTS: If my responsible physician declares my 
condition to be irreversible or incurable, I request my agent to seek innovative, investigational 
therapies. My agent is expressly authorized to enter me into NIH-approved Clinical Trials 
appropriate to my condition, whether double-blind or not.

       (2.4) OTHER WISHES: 

      (1) Under NO conditions shall I be placed in a Nursing Home.  

(2) I have Long Term Care insurance which shall be used to pay for Home Nursing Care.

      (3) If hospitalized, as long as money is available, I desire private nurses at all times.

      (4) If I should choose to take my own life, my agent is instructed not to interfere in any way.

 

DONATION OF ORGANS AT DEATH

      (3.1) Upon my death I donate any needed organs, tissues, or parts.
 

AUTHENTICATION

      (4.1) EFFECT OF COPY:  A copy of this form has the same effect as the original.
 

      (4.2) SIGNATURE: 
 
  

____________________________________
 (date)                              (signature)

[name, address]
(4.3) NOTARIZATION

State of California, County of Los Angeles

On __________________ before me, _______________________________________________
                  (name and title of Notary)

personally appeared [name], proved to me on the basis of satisfactory evidence to be the person whose
name is subscribed to the above durable power of attorney, and in my presence, by his signature,
he executed the same. 

WITNESS my hand and official seal. Signature ____________________________ 

(Seal) 

 

     
 

      




 

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