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End-of-life decisions

From Editor Thomas Mitchell:

"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."

-- America's Affordable Health Choices Act of 2009, H.R. 3200, Page 425

Too many of us are painfully familiar with the little plastic hospital wristband with the initials DNR -- which stands for do not resuscitate.

It is a symbol of the power of modern medicine over death. It is a symbol of the weakness of modern medicine's ability to sustain a life worth living.

It also raises serious questions about the role of the dominance of the individual vs. the dominance of society. It is a question as old as philosophy. To John Locke, to whom our founders looked for guidance, the individual is sovereign and governments should exist only so long as they further the rights of the individual.

But in this time of bailouts, in which individual errors are ameliorated for the sake of the social order, when some get cash for clunkers for the sake of the air we all breathe, when we contemplate end-of-life counseling as a part of legislation that spreads the cost of health care and shares the risk among the many -- when does the individual give way to the good of society as a whole?

When there are only so many transplant livers to go around, who gets one? The aging alcoholic ballplayer? The hard-living rock star? The old drunk or the young punk?

On the other hand, a 55-year-old physician with Lou Gehrig's disease wrote in Thursday's R-J about his fear of being placed interminably on a feeding tube, like Terri Schiavo, whose comatose body became a federal case. Who gets to choose? Congress or family or self? And for what reasons? To save money? To select the life most valuable to society as a whole?

"I may well be ready to die before my family and friends are ready to say goodbye," the doctor wrote. Isn't that his decision?

This is not merely an academic exercise.

An editorial in Investor's Business Daily this past week noted that one of Obama's top medical advisers is bioethicist Ezekiel Emanuel, brother of White House Chief of Staff Rahm Emanuel. This past June in the Journal of the American Medical Association, Ezekiel Emanuel wrote that "the progression in end-of-life care mentality from 'do everything' to more palliative care shows that change in physician norms and practices is possible."

He sees a move in this new social order toward "socially sustainable, cost-effective care."

So what will you decide for you and yours? Will you have a choice? Are you a sovereign individual or a drone in the social ant hill? Will you lie down and die? Or fight?

For more, visit www.lvrj.com/blogs/mitchell

Bogus ATM: Is Gaming Control Board looking into it?

From columnist John L. Smith:

A hacker noticed a bogus ATM at the Riviera Hotel Casino over the weekend while he was attending the DefCon 17 convention, multiple sources are reporting.

The ATM wasn't associated with a bank and, instead of a camera behind its screen, it featured a computer that recorded PIN numbers of users.

While not unique, the fact it was inside a local licensed casino ought to send shivers down regulatory spines.

For more, visit www.lvrj.com/blogs/smith

The 'gold gilt' congressional health care plan

From columnist Vin Suprynowicz:

Connecticut Sen. Christopher Dodd said he has been diagnosed with an early stage of prostate cancer. To set an example for the nation, even though the new thousand-page health-rationing bill they propose has not yet become law, both he and Sen. Ted Kennedy (diagnosed with inoperable brain cancer) promptly announced that ... they will each voluntarily submit their conditions and treatment options to a government-appointed panel of 20 bureaucrats, who will examine the cost and effectiveness of said treatment options for white males older than 60 years of age, and report back to them by next January as to which, if any, treatment options are allowed. ...

Oh, wait. That's not true at all. Instead, it appears Sen. Dodd announced he will have surgery early in August, that he feels fine and is "confident we're going to come out of this well."

Hey. Easy for him to say.

For more, visit www.lvrj.com/blogs/vin

Good times are here again?

From Publisher Sherman Frederick:

You must read Sen. Harry Reid's "I Am Awesome" piece from the weekend (in the Las Vegas Sun). It is a fascinating piece of reading.

I don't begrudge Harry the opportunity to present an optimistic case for recovery. God knows after the first six months of the Obama experiment we could use a little of that oft-talked-about hope.

The problem is that after six months of Obama/Pelosi/Reid, the economy in Nevada is worse, not better. This is undeniable.

Harry can say as many times as he'd like that "there is no question that (his) hard work (in the Senate) is beginning to pay off," but the proof is in the pudding. Right now our state is leading the league in bad economic news and nothing Washington has done in the past six months appears to have improved that status. ...

Recovery. Recovery. Recovery. Politicians can say it as often as they like -- and you can bet this election cycle they will. But saying it does not make it so.

For more, visit www.lvrj.com/blogs/sherm