Death panel
Encyclopedia
"Death panel", is a term that originated during a 2009 political debate regarding health care reform in the United States. The death panel claim portrayed the health care bills then pending before the U.S. Congress as encouraging euthanasia
for the elderly and as rationing health care
for the disabled and others. Angry protesters opposing the federal legislation used the term during local town hall meeting
s with U.S. Congressmen in August 2009. The term was also repeated or editorialized by politicians and commentators throughout the media.
The term "death panel" was first used in a Facebook
post by former Governor of Alaska, Sarah Palin
. In the post, Palin expanded on earlier comments by Betsy McCaughey, a longtime critic of federal health care legislation. Palin charged that the proposals—which were supported by the administration of U.S. President Barack Obama
—would put Americans, such as her elderly parents or child with Down syndrome
, at risk of being denied medical treatment if Obama's "death panel" judged them to be lacking in social worth. Both McCaughey and Palin were referring to section 1233 of bill HR 3200 which would have reimbursed physicians for counseling Medicare
patients about living wills, advance directives, and end-of-life care options. The controversial section was removed from the Senate bill and was not included in the law that was enacted, the 2010 Patient Protection and Affordable Care Act
.
Former Speaker of the House Newt Gingrich
and Senator
(Sen.) Charles Grassley (R-IA) made comments supporting Palin's charge of death panels. Similar claims were made by other opponents of the health care legislation including conservative talk radio hosts and prominent Republicans such as then-U.S. House
Minority Leader John Boehner
-(OH) and U.S. Representative Michele Bachmann
-(MN). Polls showed that about 30% of Americans thought the bills under debate did indeed establish death panels. The claim was portrayed as false by some news media
, fact-checkers, analysts, physicians, and Democrats. A handful of Republican officials including Sen. Johnny Isakson
(R-GA), and Sen. Lisa Murkowski
(R-AK) also denied that the legislation provided for death panels. Though she disagreed with many aspects of the so-called reform legislation, health policy expert Gail Wilensky
called the death panel claim a red herring
or false issue. Physician Atul Gawande
said the term represented a fear that patients might be denied expensive treatments, but he criticized many of these treatments as having major side effects that shorten patients' lives. In a January 2011 statement, the American Society of Clinical Oncology
(ASCO) criticized the politicization of the issue and recommended that the proposal to compensate physicians for counseling patients on advanced cancer treatment and care be revisited.
During a July 16 interview on the Fred Thompson Show, former lieutenant governor of New York, Betsy McCaughey, who opposed the Clinton health care plan of 1993, said HR 3200 Section 1233 was "a vicious assault on elderly people" that "would cut your life short." She charged that the legislation would mandate counseling sessions for Medicare
patients every five years to "tell them how to end their life sooner". The AARP
, a non-profit lobby group for retired persons, and the fact checking website PolitiFact both said McGaughey's claims were distorted. The AARP opined that the provision in question would actually help seniors make better decisions and would help ensure that their wishes were followed; PolitiFact noted that the proposed counseling sessions were voluntary.
After McCaughey's interview, criticism of health care reform
was broadcast on right-wing talk radio. Rush Limbaugh
repeated McCaughey's charge about mandatory counseling on his July 21 show and hosts Sean Hannity
and Laura Ingraham
picked it up. On July 24, McCaughey wrote an opinion piece for the New York Post
which claimed presidential advisor Ezekiel Emanuel thought the disabled should not be entitled to medical care, which was a precursor to Palin's eventual claim. On July 27, the article was partially read by Representative (Rep.) Michele Bachmann
(R-MN) on the floor of the House of Representatives
. Bachmann contended Emanuel was a " 'deadly doctor' who believes health care should be 'reserved for the nondisabled' ".
Rep. John Boehner
(R-OH), the then Minority Leader of the House of Representatives, repeated claims that Section 1233 would encourage euthanasia
. Boehner, along with Rep. and Republican Policy Committee Chairman Thaddeus McCotter (MI), on July 23 stated that the provision "may start us down a treacherous path toward government-encouraged euthanasia." On July 28, on the House
floor, Rep. Virginia Foxx
(R-NC) charged that a Republican alternative to the Democratic reform proposals was "pro-life because it will not put seniors in a position of being put to death by their government." On July 30, Republican Newt Gingrich
, praised the Gundersen Lutheran Medical Center
for its end-of-life practices. Speaking after a speech at the center he claimed that the House bill had "a bias toward euthanasia for senior citizens and other people."
Email and blogs were conduits. The Washington Post
reported on August 1 that on "religious e-mail lists and Internet blogs, the proposal has been described as 'guiding you in how to die', 'an ORDER from the Government to end your life', promoting 'death care' and, in the words of antiabortion leader Randall Terry
, an attempt to 'kill Granny'." In early August, members of Congress held town hall meeting
s that were marked by hostility—including shouting, comparisons between the proposed reform and Nazi Germany
arose with some sporadic, physical altercations.
, who had been keeping a low profile after her July 3, 2009, resignation from Alaska's Governorship
, was back into the headlines after using the term as part of her first Facebook
post on August 7, 2009.
The charge was debunked by PolitiFact, which stated "no panel in any version of the health care bills" judged "a person's 'level of productivity in society' to determine whether they are 'worthy' of health care." After Palin's statement, multiple commentators backed its veracity including Glenn Beck
on The Glenn Beck Program and Limbaugh on The Rush Limbaugh Show
. According to the BBC
, conservative blogger Michelle Malkin
explicitly agreed with Palin's statement that "death panels" were mandated in Obama's proposed legislation. Former House speaker Newt Gingrich backed Palin during his August 9, 2009, appearance on This Week
with George Stephanopoulos. He said the bill was a thousand pages long, set up "45 different agencies", and created "all sorts of panels." "You're asking us to trust turning power over to the government, when there clearly are people in America who believe in establishing euthanasia, including selective standards", he said. Health economist Uwe Reinhardt
said Gingrich should clarify that the provision to reimburse physicians
for end-of-life counseling had no intent to hasten death, and he mentioned Gingrich's previous support for the expanded use of advance directives.
At an August 12 town hall meeting, Republican Senator Chuck Grassley
, said people "have every right to fear ... I don't have any problem with things like living wills, but they ought to be done within the family. We should not have a government program that determines you're going to pull the plug on Grandma." Grassley later clarified that he did not think the provision would grant the government authority to decide who lives and dies. Grassley's statements at the town hall meeting were a sign that he was not on board with reform, given his role on the Senate Finance Committee as the top Senator of his party on health care.
Palin's initial August 7 Facebook post did not identify any portion of legislation. When asked of the proposed legislation mandated "death panels", a spokesperson pointed to HR 3200, Section 1233. And Palin, in an August 12 Facebook post, attempted to clarify her argument by discussing Section 1233. A few months prior to this, the provision was a separate bill with bipartisan support. The provision would have allowed physicians to receive payment from Medicare for voluntary counseling with patients on end-of-life issues which have been shown to improve the quality of life for dying patients and their families. The discussions would have been about "living wills, making a close relative or a trusted friend a health-care proxy, ... hospice as an option for the terminally ill, and ... pain medications for people suffering chronic discomfort. The sessions [would have been] covered every five years, [or] more frequently if someone was gravely ill." Supporters of the provision included the American Medical Association
(AMA), AARP
, the National Hospice and Palliative Care Organization
, and Consumers Union
; the National Right to Life Committee
opposed "the provision as written."
The provision was inserted in the bill by Democratic lawmakers encouraged by a loose coalition of hospitals led by Gundersen Lutheran
of La Crosse, Wisconsin, a hospital and community known for its widespread adoption of advance directives. Before it became HR 3200 Section 1233, Rep. Earl Blumenauer
(D-OR) had submitted the provision as separate bill in April 2009 with Republican cosponsors—Charles Boustany
(LA), a cardiovascular surgeon, Patrick Tiberi (OH), and Geoff Davis
(KY). Related legislation was enacted in 1991, the Patient Self-Determination Act
, which required health care providers, including hospitals, hospices, and nursing homes to provide information about advance directives to admitted patients. In 2003, the Medicare Prescription Drug, Improvement, and Modernization Act
provided reimbursements for end-of-life care discussion with terminally ill patients.
Consultation payments were removed from the Senate version of the bill while remaining in the House version until November 2009, when they passed, but they did not pass in the final bill
. In late December 2010, a new Medicare regulation was reported that would pay for consultations during annual wellness visits, instead of at five-year intervals as HR 3200 originally proposed, effective January 1. Instead, on January 4, the consultations were reported to be removed from the regulations.
said the phrase was used as an "outrageous allegation" to confront politicians at town hall meetings during the August 2009 congressional recess. The New York Times
said the term became a standard slogan among many conservatives opposed to the Obama administration’s health care overhaul. Health law and bioethics expert George Annas
wrote that "make believe 'death panels' that would 'pull the plug on grandma' were used as a rhetorical device to block any rational discussion of either death generally, or end of life care in particular." Brent J. Pawlecki, a corporate medical director, said the phrases "death panels" and "killing Grandma" were "used to fuel the flames of fear and opposition". Former Newsweek
editor Jon Meacham
said it was "a lie crafted to foment opposition to the president's push for reform."
Ian Dowbiggin
, a historian and published author on the history of medicine
, euthanasia, and eugenics, said "the phrase invokes images of Nazi Germany" and was "an issue that's being exploited by political figures" who are "trying to sensationalize the issue as much as possible to drum up opposition." Health economist Uwe Reinhardt
said that it is possible to slightly bend the US health care cost curve down through a lower volume of health care services "by more widespread use of living wills—an idea once actively promoted by Newt Gingrich. But those ideas were met in the past year by dark allusions to 'rationing', to Nazi-style death panels and to 'killing Granny'." Reinhardt said lowering health care costs require lowering health care incomes, and those reforms always end up being a political third rail
.
The idea that "the only way to make [health care] cost less is to deny care" was called a myth that fits with "industry executives' financial interests" by Brian Klepper, a health care analyst, and David Kibbe, a physician. Michael F. Cannon of the Cato Institute
wrote that "[p]aying doctors to help seniors sort out their preferences for end-of-life care is consumer-directed rationing, not bureaucratic rationing." The Christian Science Monitor reported that some Republicans used the term as a "jumping-off point" to discuss government rationing of health care services, while some liberal groups applied the term to private health insurance companies. Newt Gingrich, a Republican, said that while technically, the proposed legislation (HR 3200) did not provide for government rationing of health care, he alleged the legislation was "all but certain to lead to rationing."
Brendan Nyhan
, a health care policy analyst at the University of Michigan, wrote that although "efforts to reduce growth in health care costs under Obama’s plan might lead to more restrictive rationing than already occurs under the current health care system", Palin's statement as a whole was unjustified and false. Nyhan also sees attempts to label institutions which deny "coverage at a system level for specific treatments or drugs" as attempts to move the goalposts of the debate as Palin's language required that a "death panel" "would determine whether individual patients receive care based on their 'level of productivity in society'" which "was—and remains—false."
wrote that America has a "death denying culture that cannot accept death as anything but defeat." We will "prepare for any and every disease and screen for every possible 'risk factor', but we are utterly unable to prepare for death." Annas commends and quotes Boston Globe columnist Ellen Goodman
, who wrote "I think that what our [healthcare] system may need is not more intervention, but more conversation, especially on the delicate subject of dying ... More expensive care is not always better care. Doing everything can be the wrong thing. The end of life is one place where ethics and economics can still be braided into a single strand of humanity." However, Annas says mythical "death panels" blocked exploring these issues, appearing to affirm Ivan Illich
's 1975 Medical Nemesis, when he said " '[s]ocially approved death happens when man [sic] has become useless not only as a producer but also as a consumer. It is at this point that [the patient] ... must be written off as a total loss'."
Health economist James C. Robinson
said the debate over "death panels" showed how willing the public was "to believe the worst about perceived governmental interference with individual choices." Historian Jill Lepore
characterized "death panels" as a reborn conspiracy theory
that is believed by a minority of the US population after Roe v. Wade
and the Karen Ann Quinlan
case—that the federal government is conspiring to kill off its weakest members. Of the reform effort, Lepore said it was an "unwelcome reminder of a dreaded truth: death comes to us all"; of the uproar, Lepore said it rallied a party base against death, making "for a creepy sort of populism. But if harnessing the fear of death for political gain is a grotesque tactic, it may also be a savvy one." Lepore noted that after the story spread, when Obama was left saying he was not in favor of "death panels", it was an example of being "catastrophically outmaneuvered." Johnathan Oberlander
, a professor of health policy, said the Obama administration was "seemingly unprepared for the intense opposition and fury that erupted during town-hall meetings in the summer of 2009." Political scientist James Morone
said that despite Democrats denying the charge and focusing on the facts, the term played a role in their loss of control over the public debate because they did not address the "underlying fears of big government". Morone called the "death panel" arguments "pungent, memorable, simple, and effective." Journalist Paul Waldman of The American Prospect
, characterized the charge as a consequential policy lie, a falsehood that is not as condemned in media as an inconsequential personal lie.
Fox News analyst Juan Williams
said "of course there is no such thing as any death panel." Gail Wilensky
, a health adviser to President George H.W. Bush and John McCain who has overseen Medicare and Medicaid, said the charge was untrue and upsetting, adding that "[t]here are serious questions that are associated with policy aspects of the health care reform bills that we're seeing ... And there's frustration because so much of the discussion is around issues like the death panels and [Ezekiel Emanuel] that I think are red herring
s at best." Susan Dentzer
, editor of Health Affairs
, said Congress' approval of $1.1 billion for comparative effectiveness research
in the 2009 stimulus contributed to fear the research would "lead to government rationing" which "fueled the 'death panels' fury of summer 2009." The British paper, The Daily Telegraph
noted that some critics of the US reform used the United Kingdom's National Institute for Health and Clinical Excellence
(NICE)—which, as one of its functions, uses cost-effectiveness analysis (CEA) to determine whether new treatments and drugs should be available to those covered by the National Health Service
(NHS)—"as an example of the sort of drug rationing that amounted to a 'death panel'." The Sunday Times
, another British paper, wrote that Sarah Palin's use of the "death panels" term was a reference to NICE.
, a surgeon and writer, agrees that fear of missing out on an expensive life-extending treatment is behind the phrase, but he thinks framing the issue in this way completely misplaced. Gawande says "the trouble is not whether we're going to offer a $100,000 drug to help someone get 3 or 4 months"; our big trouble is that patients receive a $100,000 drug that not only yields no benefit—it also causes major side effects that shortens their lives. He said medicine has not "gotten good at making sure we are able to help people with their goals and decisions" without hurting people. Gawande said doctor's schedules—of 20 minute appointments back to back—and a lack of payments were barriers to these hour long discussions, as is the emotional difficulty in conversations that require patients to acknowledge their mortality. Geriatric psychiatrist Paul Kettl
said his experience in a geriatric unit showed end-of-life discussions and reimbursements were "desperately needed" as these hour long conversations are "ignored in the crush of medication and disease management."
The American Society of Clinical Oncology
published a statement in January 2011 advocating an individualized approach to treatment and supportive care for patients with advanced cancer and said that the issue of compensating physicians for discussing options with patients had been "unfortunately politicized", and should be revisited because "these efforts had at their core a critical patient-centered societal interest".}}
In the Journal of the American Medical Association
, Kettl wrote "I wish we had death panels. I don't mean that I'm in favor of some appointed group of erudite experts gathering to decide who lives or dies in a process controlled by the government, but rather the death panels that were originally proposed. I'm in favor of periodic discussions about advance directives that Medicare would pay for as medical visits." Kettl noted that the attention-catching phrase "death panels" became "a lightning rod for objections to a series of ideas about health care besides" end-of-life discussions, and that somehow, "the concept of physicians being paid for time to talk with patients and their families about advance directives ... generated into the fear of decisions about life and death being controlled by the government." Kettl wrote that "Emotions and health care go together. That makes them an easy and consistent target for the media and for grandstanding commentators. We can expect more good medical ideas to be destroyed by sound bytes and needless concerns that will be exaggerated. It makes for good television, but bad medicine."
Benjamin W. Corn, a cancer specialist, wrote in the New England Journal of Medicine
that the "death panels" controversy showed Americans were uneasy discussing topics related to the dying process. Corn supports the end-of-life care conversations, as he says that they can have an important positive effect on patients. Corn offered suggestions on how to present to conversations to patients, but he said some patients may not ever welcome them. Corn thinks certain issues, such as whether experimental therapies should be reimbursed, the possible expansion of hospices, restoring dignity to the process of dying, and guidelines for physician assisted suicide, need to be addressed directly.
(R-AK) stated that "death panels" were a baseless charge that unnecessarily incited fear and detracted from real problems in the proposed legislation. She said it was "bad enough that we don't need to be making things up". Sen. Johnny Isakson
(R-GA), thought there was illogical confusion over "death panels"; he said advance directives put "authority in the individual rather than the government." In July 2010 Rep. Bob Inglis
, (R-SC) said that he thought it was counterproductive for the conservative movement for some to promote misinformation about death panels when they do not exist. Rep. Darrell Issa
(R-CA) said that he agrees with his colleague, Rep. Charles Boustany
(R-LA), a surgeon. As quoted in The Wall Street Journal
, Issa, referencing Boustany, said "medical panels of people who care about what's best for their patients ... is good science and good medicine." Speaking for himself, Issa said "Republicans have to step back from the words 'death panels'."
Rep. Earl Blumenauer
(D-OR) called the references to "death panels" or euthanasia "mind-numbing" and "a terrible falsehood". He thought that the news media contributed to the persistence of the myth by amplifying misinformation and extreme behavior. When a regulation for reimbursing consultation payments was upcoming, Blumenauer cautioned supporters to keep things quiet, reasoning that Republican leaders would attempt to continue the myth. President Barack Obama cited the charge—along with the citizenship conspiracy theories
and "job-killing" allegations—as demagogy
against him. In testimony to the United States Congress Joint Select Committee on Deficit Reduction
, Erskine Bowles
(D), co-chair of the National Commission on Fiscal Responsibility and Reform
, called "death panels" "a kind of crazy stuff" and added that end-of-life care in the U.S. needed reform.
led the responses, saying "I wouldn't be alive today if it weren't for the NHS."
In a September 2009 speech in Hong Kong, Palin said the term was "intended to sound a warning about the rationing that is sure to follow if big government tries to simultaneously increase health care coverage while also claiming to decrease costs." In November 2009 Palin said that Obama was "incorrect" and "disingenuous" when he called the "death panel" charge "a lie, plain and simple." In the National Review
she said
She explained that the term should not be taken literally, likening it to when President Ronald Reagan
called the Soviet Union, the "Evil Empire
." "He got his point across. He got people thinking and researching what he was talking about. It was quite effective. Same thing with the 'death panels'. I would characterize them like that again, in a heartbeat", she said. Media Matters
stated that "Palin's claim of 'death panels' bureaucrats deciding who is 'worthy of health care' is simply false, regardless of whether she meant it literally or figuratively."
In December 2009 Palin warned on Twitter that a merged health care bill could have the "death panels" restored. In October 2010, Palin defended her use of the term in a Newsmax.com interview. Palin said she
Palin used the term in a joke while speaking at the 2009 Gridiron Club
dinner, saying "It is good to be here and in front of this audience of leading journalists and intellectuals. Or, as I call it, a death panel."
By mid-August 2009, about a week after Palin's initial Facebook note, the Pew Research Center
reported that 86% of Americans had heard of the "death panels" charge. Out of those who had heard the charge, 30% of people thought it was true while 20% did not know. For Republicans, 47% thought it was true while 23% did not know. Oberlander said the false warnings of a government takeover and "death panels" from Republicans drowned out the "Democrats' focus group–tested mantra of 'quality, affordable health care' ". Morone said the White House was not able to offer a "persuasive narrative to counter the Tea Party percussion", and "struggled to recapture public attention", contributing to Republican Scott Brown
's election. The election of Brown in the special Senate election in Massachusetts
was a surprise victory for Republicans and a setback for the chance of health care reform under Democratic leadership; Brown won the historical Senate seat of the late Democrat Ted Kennedy
, ending the Democrat's supermajority
of 60 in the Senate.
In September 2010, six months after the passage of the Affordable Care Act, a BBC
article stated that among the "sticky charges" that had stuck against the bill was the false charge of "government 'death panels' deciding who can get what sort of care". A survey by the Regence Foundation and National Journal
released in 2011 showed 40% of Americans knew that the "death panels" were not in the Affordable Care Act, while 23% said they thought the law allowed government to make end-of-life care decisions on behalf of seniors, and 36% said they did not know. Other findings from the survey included:
, a physician who writes on health care topics for The New Yorker
, said "that the whole death panel reduction and reaction to it" temporarily "shut down our ability to even have a national discussion about how to have the right [end-of-life] conversation" between doctors and patients.
When investigating for his article "Letting Go", Gawande was asked to refrain from writing about palliative care
by physicians who were concerned the article might be manipulated to create another political controversy—and as a result, hurt their profession. Professor Harold Pollack
wrote that given the "anxieties captured in the crystalline phrase 'death panel,' I would not commence a national cost-control discussion within the frightening and divisive arena of end-of-life care."
Bishop et al. were fearful of how their publication on CPR/DNR
would be received by the medical and bioethics communities. They were concerned because in "the era of rhetoric centered on fictional 'death panels' " their paper addressed "the quest for immortality implicit in US culture, a culture of 'life-at-all costs' that medical technology has advanced". Bishop et al. interpreted cautioning comments from their peers as a suggestion "that land mines of 'death panels' await us".
PolitiFact.com
gave Palin's claim its lowest rating—"Pants on Fire!"—on August 10 and on December 19 it was named "Lie of the Year" for 2009. "Death panel" was named the most outrageous term of 2009 by the American Dialect Society
. The definition was given as "A supposed committee of doctors and/or bureaucrats who would decide which patients were allowed to receive treatment, ostensibly leaving the rest to die". FactCheck
called it one of the "whoppers" of 2009.
called the topic "irresistable" to reporters because it covered conflict, drama, innuendo, and Sarah Palin. Garber said it was "notoriously challenging for the press to deal with" because the old method of deligitmization—ignoring—was no longer workable. "Debunking rumors without simultaneously sanctioning them has always been a fraught endeavor, with the proliferation of niche media sites over the past several years only rendering that effort even more precarious," said Garber.
A study by Regina G. Lawrence, a communications professor, and Matthew L. Schafer, a Juris Doctor
candidate, found that "the mainstream news, particularly newspapers, debunked 'death panels' early, fairly often, and in a variety of ways, though some were more direct than others." Of the journalists that reported the charge as false, 30% presented information in a he said/she said style, often confusing readers. Of the reports that presented "death panels" as false, 75% did not include an explanation. Lawrence and Schafer said that "the dilemma for reporters playing by the rules of procedural objectivity is that repeating a claim reinforces a sense of its validity—or at least, enshrines its place as an important topic of public debate. Moreover, there is no clear evidence that journalism can correct misinformation once it has been widely publicized. Indeed, it didn't seem to correct the death panels misinformation in our study."
Brendan Nyhan concluded his study on the "death panel" myth with two recommendations to improve future media performance.
which cut Medicaid
funding for previously approved transplants, E.J. Montini of The Arizona Republic
used the term, as did Keith Olbermann
of MSNBC
. Montini referred to Republican Governor Jan Brewer
as "Governor Grim Reaper" and both Brewer and the Republican-controlled legislature as a "death panel". An editorial by USA Today
said, "to the extent that death panels of a sort do exist, they're composed of state officials who must decide whether each state's version of Medicaid will cover certain expensive, potentially life-saving treatments."
Palin applied the term to the IPAB. After the National Commission on Fiscal Responsibility and Reform
released its recommendation to strengthen the IPAB, she charged in the Wall Street Journal that the board was " 'death panel'-like". FactCheck
found her characterization of the board wrong on three counts. Representative Phil Roe
(Republican-Tennessee), who has twice sponsored bills to eliminate the IPAB, said he would associate the term with the IPAB. Roe was described by the The Washington Post
as "a kindred soul by the medical industry" in part for his legislative efforts against the IPAB and a "magnet during the last election for more than $90,000 in contributions from medical professionals from across the country". Rep. Phil Gingrey
(Republican-Georgia), an OB/GYN, issued a factually inaccurate statement, described by PolitiFact as outrageous, that was in line with the "death panels" narrative.
In October 2010, The Philadelphia Inquirer
highlighted the term in its "The Week in Words" article after Barney Frank
said the only "death panels" created by congressional Democrats were for troubled financial institutions under the authority of the Dodd–Frank Bill.
In November 2010, Paul Krugman
was deliberately provocative on This Week, calling for "death panels and sales taxes" to fix the budget deficit
. Krugman clarified that "health care costs will have to be controlled, which will surely require having Medicare and Medicaid decide what they’re willing to pay for—not really death panels, of course, but consideration of medical effectiveness and, at some point, how much we’re willing to spend for extreme care."
In his 2011 book, Mike Huckabee claimed that the Federal Coordinating Council for Comparative Effectiveness from the 2009 stimulus were the seeds from which "the poisonous tree of death panels will grow." Media Matters called this a "lie"; it reported that Huckabee mischaracterized the council and that it was eliminated in the 2010 health care reform. Paul Van de Water of the Center on Budget and Policy Priorities
, said "Huckabee seems to be suggesting that we shouldn't do research to find out what medical procedures work best just because that research could conceivably be misused. The new law makes every effort to assure that won't happen."
Euthanasia
Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering....
for the elderly and as rationing health care
Health care rationing
Health care rationing refers to governmental mechanisms that are used to allocate health care when resources are scarce. Countries differ upon the mechanisms they use to ration the distribution of health care...
for the disabled and others. Angry protesters opposing the federal legislation used the term during local town hall meeting
Town hall meeting
A town hall meeting is an American English term given to an informal public meeting. Everybody in a town community is invited to attend, not always to voice their opinions, but to hear the responses from public figures and elected officials about shared subjects of interest. Attendees rarely voted...
s with U.S. Congressmen in August 2009. The term was also repeated or editorialized by politicians and commentators throughout the media.
The term "death panel" was first used in a Facebook
Facebook
Facebook is a social networking service and website launched in February 2004, operated and privately owned by Facebook, Inc. , Facebook has more than 800 million active users. Users must register before using the site, after which they may create a personal profile, add other users as...
post by former Governor of Alaska, Sarah Palin
Sarah Palin
Sarah Louise Palin is an American politician, commentator and author. As the Republican Party nominee for Vice President in the 2008 presidential election, she was the first Alaskan on the national ticket of a major party and first Republican woman nominated for the vice-presidency.She was...
. In the post, Palin expanded on earlier comments by Betsy McCaughey, a longtime critic of federal health care legislation. Palin charged that the proposals—which were supported by the administration of U.S. President Barack Obama
Barack Obama
Barack Hussein Obama II is the 44th and current President of the United States. He is the first African American to hold the office. Obama previously served as a United States Senator from Illinois, from January 2005 until he resigned following his victory in the 2008 presidential election.Born in...
—would put Americans, such as her elderly parents or child with Down syndrome
Down syndrome
Down syndrome, or Down's syndrome, trisomy 21, is a chromosomal condition caused by the presence of all or part of an extra 21st chromosome. It is named after John Langdon Down, the British physician who described the syndrome in 1866. The condition was clinically described earlier in the 19th...
, at risk of being denied medical treatment if Obama's "death panel" judged them to be lacking in social worth. Both McCaughey and Palin were referring to section 1233 of bill HR 3200 which would have reimbursed physicians for counseling Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
patients about living wills, advance directives, and end-of-life care options. The controversial section was removed from the Senate bill and was not included in the law that was enacted, the 2010 Patient Protection and Affordable Care Act
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
.
Former Speaker of the House Newt Gingrich
Newt Gingrich
Newton Leroy "Newt" Gingrich is a U.S. Republican Party politician who served as the House Minority Whip from 1989 to 1995 and as the 58th Speaker of the U.S. House of Representatives from 1995 to 1999....
and Senator
United States Senate
The United States Senate is the upper house of the bicameral legislature of the United States, and together with the United States House of Representatives comprises the United States Congress. The composition and powers of the Senate are established in Article One of the U.S. Constitution. Each...
(Sen.) Charles Grassley (R-IA) made comments supporting Palin's charge of death panels. Similar claims were made by other opponents of the health care legislation including conservative talk radio hosts and prominent Republicans such as then-U.S. House
United States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...
Minority Leader John Boehner
John Boehner
John Andrew Boehner is the 61st and current Speaker of the United States House of Representatives. A member of the Republican Party, he is the U.S. Representative from , serving since 1991...
-(OH) and U.S. Representative Michele Bachmann
Michele Bachmann
Michele Marie Bachmann is a Republican member of the United States House of Representatives, representing , a post she has held since 2007. The district includes several of the northern suburbs of the Twin Cities, such as Woodbury, and Blaine as well as Stillwater and St. Cloud.She is currently a...
-(MN). Polls showed that about 30% of Americans thought the bills under debate did indeed establish death panels. The claim was portrayed as false by some news media
News media
The news media are those elements of the mass media that focus on delivering news to the general public or a target public.These include print media , broadcast news , and more recently the Internet .-Etymology:A medium is a carrier of something...
, fact-checkers, analysts, physicians, and Democrats. A handful of Republican officials including Sen. Johnny Isakson
Johnny Isakson
John Hardy "Johnny" Isakson is the junior United States Senator from Georgia and a member of the Republican Party. Previously, he represented in the House....
(R-GA), and Sen. Lisa Murkowski
Lisa Murkowski
Lisa Ann Murkowski is the senior U.S. Senator from the State of Alaska and a member of the Republican Party. She was appointed to the Senate in 2002 by her father, Governor Frank Murkowski. After losing a Republican primary in 2010, she became the second person ever to win a U.S...
(R-AK) also denied that the legislation provided for death panels. Though she disagreed with many aspects of the so-called reform legislation, health policy expert Gail Wilensky
Gail Wilensky
Gail R. Wilensky is an American health economist who has worked for Republican administrations and candidacies. Wilensky headed Medicare under the first president Bush and works at Project HOPE.-External links:**...
called the death panel claim a red herring
Red herring
A red herring is a deliberate attempt to divert attention.Red herring may refer to:* Red herring , the informal fallacy of presenting an argument that may in itself be valid, but does not address the issue in question....
or false issue. Physician Atul Gawande
Atul Gawande
Atul Gawande is an American physician and journalist. He serves as a general and endocrine surgeon at Brigham and Women's Hospital in Boston, Massachusetts and associate director of their Center for Surgery and Public Health...
said the term represented a fear that patients might be denied expensive treatments, but he criticized many of these treatments as having major side effects that shorten patients' lives. In a January 2011 statement, the American Society of Clinical Oncology
American Society of Clinical Oncology
The American Society of Clinical Oncology is the world's leading professional organization representing physicians of all oncology subspecialties who care for people with cancer. Founded in 1964 by Drs...
(ASCO) criticized the politicization of the issue and recommended that the proposal to compensate physicians for counseling patients on advanced cancer treatment and care be revisited.
Background
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
patients every five years to "tell them how to end their life sooner". The AARP
AARP
AARP, formerly the American Association of Retired Persons, is the United States-based non-governmental organization and interest group, founded in 1958 by Ethel Percy Andrus, PhD, a retired educator from California, and based in Washington, D.C. According to its mission statement, it is "a...
, a non-profit lobby group for retired persons, and the fact checking website PolitiFact both said McGaughey's claims were distorted. The AARP opined that the provision in question would actually help seniors make better decisions and would help ensure that their wishes were followed; PolitiFact noted that the proposed counseling sessions were voluntary.
After McCaughey's interview, criticism of health care reform
Health care reform
Health care reform is a general rubric used for discussing major health policy creation or changes—for the most part, governmental policy that affects health care delivery in a given place...
was broadcast on right-wing talk radio. Rush Limbaugh
Rush Limbaugh
Rush Hudson Limbaugh III is an American radio talk show host, conservative political commentator, and an opinion leader in American conservatism. He hosts The Rush Limbaugh Show which is aired throughout the U.S. on Premiere Radio Networks and is the highest-rated talk-radio program in the United...
repeated McCaughey's charge about mandatory counseling on his July 21 show and hosts Sean Hannity
Sean Hannity
Sean Hannity is an American radio and television host, author, and conservative political commentator. He is the host of The Sean Hannity Show, a nationally syndicated talk radio show that airs throughout the United States on Premiere Radio Networks. Hannity also hosts a cable news show, Hannity,...
and Laura Ingraham
Laura Ingraham
Laura Anne Ingraham is an American radio host, author, and conservative political commentator. Her nationally syndicated talk show, The Laura Ingraham Show, airs throughout the United States on Talk Radio Network...
picked it up. On July 24, McCaughey wrote an opinion piece for the New York Post
New York Post
The New York Post is the 13th-oldest newspaper published in the United States and is generally acknowledged as the oldest to have been published continuously as a daily, although – as is the case with most other papers – its publication has been periodically interrupted by labor actions...
which claimed presidential advisor Ezekiel Emanuel thought the disabled should not be entitled to medical care, which was a precursor to Palin's eventual claim. On July 27, the article was partially read by Representative (Rep.) Michele Bachmann
Michele Bachmann
Michele Marie Bachmann is a Republican member of the United States House of Representatives, representing , a post she has held since 2007. The district includes several of the northern suburbs of the Twin Cities, such as Woodbury, and Blaine as well as Stillwater and St. Cloud.She is currently a...
(R-MN) on the floor of the House of Representatives
United States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...
. Bachmann contended Emanuel was a " 'deadly doctor' who believes health care should be 'reserved for the nondisabled' ".
John Boehner
John Andrew Boehner is the 61st and current Speaker of the United States House of Representatives. A member of the Republican Party, he is the U.S. Representative from , serving since 1991...
(R-OH), the then Minority Leader of the House of Representatives, repeated claims that Section 1233 would encourage euthanasia
Euthanasia
Euthanasia refers to the practice of intentionally ending a life in order to relieve pain and suffering....
. Boehner, along with Rep. and Republican Policy Committee Chairman Thaddeus McCotter (MI), on July 23 stated that the provision "may start us down a treacherous path toward government-encouraged euthanasia." On July 28, on the House
United States House of Representatives
The United States House of Representatives is one of the two Houses of the United States Congress, the bicameral legislature which also includes the Senate.The composition and powers of the House are established in Article One of the Constitution...
floor, Rep. Virginia Foxx
Virginia Foxx
Virginia Foxx is the U.S. Representative for , serving since 2005. She is a member of the Republican Party. The district takes in much of the northwestern portion of the state and a portion of Winston-Salem....
(R-NC) charged that a Republican alternative to the Democratic reform proposals was "pro-life because it will not put seniors in a position of being put to death by their government." On July 30, Republican Newt Gingrich
Newt Gingrich
Newton Leroy "Newt" Gingrich is a U.S. Republican Party politician who served as the House Minority Whip from 1989 to 1995 and as the 58th Speaker of the U.S. House of Representatives from 1995 to 1999....
, praised the Gundersen Lutheran Medical Center
Gundersen Lutheran Medical Center
Gundersen Lutheran Medical Center a comprehensive health care network including one of the nation's largest multi-specialty group medical practices, regional community clinics, hospital, home care, behavioral health services, vision centers, pharmacies, and air and ground ambulances.Gundersen...
for its end-of-life practices. Speaking after a speech at the center he claimed that the House bill had "a bias toward euthanasia for senior citizens and other people."
Email and blogs were conduits. The Washington Post
The Washington Post
The Washington Post is Washington, D.C.'s largest newspaper and its oldest still-existing paper, founded in 1877. Located in the capital of the United States, The Post has a particular emphasis on national politics. D.C., Maryland, and Virginia editions are printed for daily circulation...
reported on August 1 that on "religious e-mail lists and Internet blogs, the proposal has been described as 'guiding you in how to die', 'an ORDER from the Government to end your life', promoting 'death care' and, in the words of antiabortion leader Randall Terry
Randall Terry
Randall Almira Terry is an American pro-life activist and candidate for the Democratic Party's nomination for President in 2012. Terry founded the pro-life organization Operation Rescue. The group became particularly prominent beginning in 1987 for blockading the entrances to abortion clinics;...
, an attempt to 'kill Granny'." In early August, members of Congress held town hall meeting
Town hall meeting
A town hall meeting is an American English term given to an informal public meeting. Everybody in a town community is invited to attend, not always to voice their opinions, but to hear the responses from public figures and elected officials about shared subjects of interest. Attendees rarely voted...
s that were marked by hostility—including shouting, comparisons between the proposed reform and Nazi Germany
Nazi Germany
Nazi Germany , also known as the Third Reich , but officially called German Reich from 1933 to 1943 and Greater German Reich from 26 June 1943 onward, is the name commonly used to refer to the state of Germany from 1933 to 1945, when it was a totalitarian dictatorship ruled by...
arose with some sporadic, physical altercations.
Palin's initial reference
Sarah PalinSarah Palin
Sarah Louise Palin is an American politician, commentator and author. As the Republican Party nominee for Vice President in the 2008 presidential election, she was the first Alaskan on the national ticket of a major party and first Republican woman nominated for the vice-presidency.She was...
, who had been keeping a low profile after her July 3, 2009, resignation from Alaska's Governorship
Resignation of Sarah Palin
The resignation of Sarah Palin as Governor of Alaska was announced on July 3, 2009 and became effective on July 26. Sean Parnell, the lieutenant governor, took Palin's place as governor.-Reasons for the resignation:...
, was back into the headlines after using the term as part of her first Facebook
Facebook
Facebook is a social networking service and website launched in February 2004, operated and privately owned by Facebook, Inc. , Facebook has more than 800 million active users. Users must register before using the site, after which they may create a personal profile, add other users as...
post on August 7, 2009.
The charge was debunked by PolitiFact, which stated "no panel in any version of the health care bills" judged "a person's 'level of productivity in society' to determine whether they are 'worthy' of health care." After Palin's statement, multiple commentators backed its veracity including Glenn Beck
Glenn Beck
Glenn Edward Lee Beck is an American conservative radio host, vlogger, author, entrepreneur, political commentator and former television host. He hosts the Glenn Beck Program, a nationally syndicated talk-radio show that airs throughout the United States on Premiere Radio Networks...
on The Glenn Beck Program and Limbaugh on The Rush Limbaugh Show
The Rush Limbaugh Show
The Rush Limbaugh Show is an American talk radio show hosted by Rush Limbaugh on Premiere Radio Networks...
. According to the BBC
BBC
The British Broadcasting Corporation is a British public service broadcaster. Its headquarters is at Broadcasting House in the City of Westminster, London. It is the largest broadcaster in the world, with about 23,000 staff...
, conservative blogger Michelle Malkin
Michelle Malkin
Michelle Malkin is an American conservative blogger, political commentator, and author. Her weekly syndicated column appears in a number of newspapers and websites. She is a Fox News Channel contributor and has been a guest on MSNBC, C-SPAN, and national radio programs...
explicitly agreed with Palin's statement that "death panels" were mandated in Obama's proposed legislation. Former House speaker Newt Gingrich backed Palin during his August 9, 2009, appearance on This Week
This Week (ABC TV series)
This Week is ABC's Sunday morning political affairs program.The Sunday morning talk show has aired on Sunday mornings on ABC since 1981; the program is initially aired at 9:00 AM ET, although many stations air the program later, especially those in other time zones...
with George Stephanopoulos. He said the bill was a thousand pages long, set up "45 different agencies", and created "all sorts of panels." "You're asking us to trust turning power over to the government, when there clearly are people in America who believe in establishing euthanasia, including selective standards", he said. Health economist Uwe Reinhardt
Uwe Reinhardt
Uwe E. Reinhardt is a professor of political economy at Princeton University and holds several positions in the healthcare industry. Reinhardt is a prominent scholar in health care economics and a frequent speaker and author on subjects ranging from the war in Iraq to the future of Medicare.-...
said Gingrich should clarify that the provision to reimburse physicians
Physicians in the United States
Physicians in the United States include both ones trained by medical education in the United States and ones that are international medical graduates who have progressed through the necessary steps to acquire a medical license to practice in a state...
for end-of-life counseling had no intent to hasten death, and he mentioned Gingrich's previous support for the expanded use of advance directives.
At an August 12 town hall meeting, Republican Senator Chuck Grassley
Chuck Grassley
Charles Ernest "Chuck" Grassley is the senior United States Senator from Iowa . A member of Republican Party, he previously served in the served in the United States House of Representatives and the Iowa state legislature...
, said people "have every right to fear ... I don't have any problem with things like living wills, but they ought to be done within the family. We should not have a government program that determines you're going to pull the plug on Grandma." Grassley later clarified that he did not think the provision would grant the government authority to decide who lives and dies. Grassley's statements at the town hall meeting were a sign that he was not on board with reform, given his role on the Senate Finance Committee as the top Senator of his party on health care.
Legislation
American Medical Association
The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...
(AMA), AARP
AARP
AARP, formerly the American Association of Retired Persons, is the United States-based non-governmental organization and interest group, founded in 1958 by Ethel Percy Andrus, PhD, a retired educator from California, and based in Washington, D.C. According to its mission statement, it is "a...
, the National Hospice and Palliative Care Organization
National Hospice and Palliative Care Organization
The National Hospice and Palliative Care Organization is a nonprofit organization based in the Alexandria, Virginia. It focuses on issues relating to hospice and palliative care. Its philosophy statement on hospice is that it "affirms life and neither hastens nor postpones death."...
, and Consumers Union
Consumers Union
Consumers Union is a non-profit organization best known as the publisher of Consumer Reports, based in the United States. Its mission is to "test products, inform the public, and protect consumers."...
; the National Right to Life Committee
National Right to Life Committee
The National Right to Life Committee is the oldest and largest pro-life organization in the United States with affiliates in all 50 states and over 3,000 local chapters nationwide. The group works through legislation and education to work against abortion, infanticide, euthanasia and assisted...
opposed "the provision as written."
The provision was inserted in the bill by Democratic lawmakers encouraged by a loose coalition of hospitals led by Gundersen Lutheran
Gundersen Lutheran Medical Center
Gundersen Lutheran Medical Center a comprehensive health care network including one of the nation's largest multi-specialty group medical practices, regional community clinics, hospital, home care, behavioral health services, vision centers, pharmacies, and air and ground ambulances.Gundersen...
of La Crosse, Wisconsin, a hospital and community known for its widespread adoption of advance directives. Before it became HR 3200 Section 1233, Rep. Earl Blumenauer
Earl Blumenauer
Earl Blumenauer is the U.S. Representative for , serving since 1996. He is a member of the Democratic Party. The district includes most of Portland east of the Willamette River. A native of Portland, he previously spent over 20 years as a public official representing the city.-Early...
(D-OR) had submitted the provision as separate bill in April 2009 with Republican cosponsors—Charles Boustany
Charles Boustany
Charles William Boustany, Jr. is the U.S. Representative for , serving since 2005. He is a member of the Republican Party.-Early life, education, and medical career:...
(LA), a cardiovascular surgeon, Patrick Tiberi (OH), and Geoff Davis
Geoff Davis
Geoffrey C. "Geoff" Davis is the U.S. Representative for , serving since 2005. He is a member of the Republican Party....
(KY). Related legislation was enacted in 1991, the Patient Self-Determination Act
Patient Self-Determination Act
The Patient Self-Determination Act was passed by the U.S. Congress in 1990 as an amendment to the Omnibus Budget Reconciliation Act of 1990...
, which required health care providers, including hospitals, hospices, and nursing homes to provide information about advance directives to admitted patients. In 2003, the Medicare Prescription Drug, Improvement, and Modernization Act
Medicare Prescription Drug, Improvement, and Modernization Act
The Medicare Prescription Drug, Improvement, and Modernization Act is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.The MMA was signed by President George W...
provided reimbursements for end-of-life care discussion with terminally ill patients.
Consultation payments were removed from the Senate version of the bill while remaining in the House version until November 2009, when they passed, but they did not pass in the final bill
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
. In late December 2010, a new Medicare regulation was reported that would pay for consultations during annual wellness visits, instead of at five-year intervals as HR 3200 originally proposed, effective January 1. Instead, on January 4, the consultations were reported to be removed from the regulations.
Reaction
The EconomistThe Economist
The Economist is an English-language weekly news and international affairs publication owned by The Economist Newspaper Ltd. and edited in offices in the City of Westminster, London, England. Continuous publication began under founder James Wilson in September 1843...
said the phrase was used as an "outrageous allegation" to confront politicians at town hall meetings during the August 2009 congressional recess. The New York Times
The New York Times
The New York Times is an American daily newspaper founded and continuously published in New York City since 1851. The New York Times has won 106 Pulitzer Prizes, the most of any news organization...
said the term became a standard slogan among many conservatives opposed to the Obama administration’s health care overhaul. Health law and bioethics expert George Annas
George Annas
George J. Annas is the William Fairfield Warren Distinguished Professor and Chair of the Department of Health Law, Bioethics & Human Rights at the Boston University School of Public Health, School of Medicine, and School of Law. He holds a bachelor's degree in economics from Harvard College, a J.D....
wrote that "make believe 'death panels' that would 'pull the plug on grandma' were used as a rhetorical device to block any rational discussion of either death generally, or end of life care in particular." Brent J. Pawlecki, a corporate medical director, said the phrases "death panels" and "killing Grandma" were "used to fuel the flames of fear and opposition". Former Newsweek
Newsweek
Newsweek is an American weekly news magazine published in New York City. It is distributed throughout the United States and internationally. It is the second-largest news weekly magazine in the U.S., having trailed Time in circulation and advertising revenue for most of its existence...
editor Jon Meacham
Jon Meacham
Jon Meacham is executive editor and executive vice president at Random House. A former editor of Newsweek and a Pulitzer Prize winning bestselling author and a commentator on politics, history, and religious faith in America, he is a contributing editor to Time magazine and editor-at-large of WNET...
said it was "a lie crafted to foment opposition to the president's push for reform."
Ian Dowbiggin
Ian Dowbiggin
Ian Robert Dowbiggin is an academic historian, a historian of medicine, a prominent commentator on Catholicism, and an opponent of euthanasia and physician-assisted suicide. He is a professor in the History department at the University of Prince Edward Island...
, a historian and published author on the history of medicine
History of medicine
All human societies have medical beliefs that provide explanations for birth, death, and disease. Throughout history, illness has been attributed to witchcraft, demons, astral influence, or the will of the gods...
, euthanasia, and eugenics, said "the phrase invokes images of Nazi Germany" and was "an issue that's being exploited by political figures" who are "trying to sensationalize the issue as much as possible to drum up opposition." Health economist Uwe Reinhardt
Uwe Reinhardt
Uwe E. Reinhardt is a professor of political economy at Princeton University and holds several positions in the healthcare industry. Reinhardt is a prominent scholar in health care economics and a frequent speaker and author on subjects ranging from the war in Iraq to the future of Medicare.-...
said that it is possible to slightly bend the US health care cost curve down through a lower volume of health care services "by more widespread use of living wills—an idea once actively promoted by Newt Gingrich. But those ideas were met in the past year by dark allusions to 'rationing', to Nazi-style death panels and to 'killing Granny'." Reinhardt said lowering health care costs require lowering health care incomes, and those reforms always end up being a political third rail
Third rail (metaphor)
The phrase third rail is a metaphor in politics to denote an idea or topic that is so "charged" and "untouchable" that any politician or public official who dares to broach the subject would invariably suffer politically.-Denotation:...
.
The idea that "the only way to make [health care] cost less is to deny care" was called a myth that fits with "industry executives' financial interests" by Brian Klepper, a health care analyst, and David Kibbe, a physician. Michael F. Cannon of the Cato Institute
Cato Institute
The Cato Institute is a libertarian think tank headquartered in Washington, D.C. It was founded in 1977 by Edward H. Crane, who remains president and CEO, and Charles Koch, chairman of the board and chief executive officer of the conglomerate Koch Industries, Inc., the largest privately held...
wrote that "[p]aying doctors to help seniors sort out their preferences for end-of-life care is consumer-directed rationing, not bureaucratic rationing." The Christian Science Monitor reported that some Republicans used the term as a "jumping-off point" to discuss government rationing of health care services, while some liberal groups applied the term to private health insurance companies. Newt Gingrich, a Republican, said that while technically, the proposed legislation (HR 3200) did not provide for government rationing of health care, he alleged the legislation was "all but certain to lead to rationing."
Brendan Nyhan
Brendan Nyhan
Brendan Nyhan is an American liberal to moderate political blogger, author, and political columnist. He was born in Mountain View, California and now lives in Ann Arbor, Michigan.-Education:...
, a health care policy analyst at the University of Michigan, wrote that although "efforts to reduce growth in health care costs under Obama’s plan might lead to more restrictive rationing than already occurs under the current health care system", Palin's statement as a whole was unjustified and false. Nyhan also sees attempts to label institutions which deny "coverage at a system level for specific treatments or drugs" as attempts to move the goalposts of the debate as Palin's language required that a "death panel" "would determine whether individual patients receive care based on their 'level of productivity in society'" which "was—and remains—false."
Academic and media
Bioethicist George AnnasGeorge Annas
George J. Annas is the William Fairfield Warren Distinguished Professor and Chair of the Department of Health Law, Bioethics & Human Rights at the Boston University School of Public Health, School of Medicine, and School of Law. He holds a bachelor's degree in economics from Harvard College, a J.D....
wrote that America has a "death denying culture that cannot accept death as anything but defeat." We will "prepare for any and every disease and screen for every possible 'risk factor', but we are utterly unable to prepare for death." Annas commends and quotes Boston Globe columnist Ellen Goodman
Ellen Goodman
Ellen Goodman is an American journalist and Pulitzer Prize-winning syndicated columnist.- Career :Goodman worked as a researcher and reporter for Newsweek magazine between 1963 and 1965, and has worked as an associate editor at the Boston Globe since 1967.In 1998, Goodman received the Elijah...
, who wrote "I think that what our [healthcare] system may need is not more intervention, but more conversation, especially on the delicate subject of dying ... More expensive care is not always better care. Doing everything can be the wrong thing. The end of life is one place where ethics and economics can still be braided into a single strand of humanity." However, Annas says mythical "death panels" blocked exploring these issues, appearing to affirm Ivan Illich
Ivan Illich
Ivan Illich was an Austrian philosopher, Roman Catholic priest, and "maverick social critic" of the institutions of contemporary western culture and their effects on the provenance and practice of education, medicine, work, energy use, transportation, and economic development.- Personal life...
's 1975 Medical Nemesis, when he said " '[s]ocially approved death happens when man [sic] has become useless not only as a producer but also as a consumer. It is at this point that [the patient] ... must be written off as a total loss'."
Health economist James C. Robinson
James C. Robinson (health economist)
James C. Robinson is a professor of health economics at the University of California, Berkeley's school of public health. At Berkeley, he has the title of the Kaiser Permanente Distinguished Professor of Health Economics. Robinson is a contributing editor for the peer-reviewed academic journal...
said the debate over "death panels" showed how willing the public was "to believe the worst about perceived governmental interference with individual choices." Historian Jill Lepore
Jill Lepore
Jill Lepore is a professor of American history at Harvard University and chair of Harvard's History and Literature Program. She is a contributing writer at The New Yorker, and her essays and reviews have also appeared in The New York Times, the Los Angeles Times, The American Scholar, and in...
characterized "death panels" as a reborn conspiracy theory
Conspiracy theory
A conspiracy theory explains an event as being the result of an alleged plot by a covert group or organization or, more broadly, the idea that important political, social or economic events are the products of secret plots that are largely unknown to the general public.-Usage:The term "conspiracy...
that is believed by a minority of the US population after Roe v. Wade
Roe v. Wade
Roe v. Wade, , was a controversial landmark decision by the United States Supreme Court on the issue of abortion. The Court decided that a right to privacy under the due process clause in the Fourteenth Amendment to the United States Constitution extends to a woman's decision to have an abortion,...
and the Karen Ann Quinlan
Karen Ann Quinlan
Karen Ann Quinlan was an important figure in the history of the right to die controversy in the United States....
case—that the federal government is conspiring to kill off its weakest members. Of the reform effort, Lepore said it was an "unwelcome reminder of a dreaded truth: death comes to us all"; of the uproar, Lepore said it rallied a party base against death, making "for a creepy sort of populism. But if harnessing the fear of death for political gain is a grotesque tactic, it may also be a savvy one." Lepore noted that after the story spread, when Obama was left saying he was not in favor of "death panels", it was an example of being "catastrophically outmaneuvered." Johnathan Oberlander
Johnathan Oberlander
Jonathan Oberlander is a professor of social medicine at the University of North Carolina at Chapel Hill and author of the 2003 book The Political Life of Medicare.-External links:*...
, a professor of health policy, said the Obama administration was "seemingly unprepared for the intense opposition and fury that erupted during town-hall meetings in the summer of 2009." Political scientist James Morone
James Morone
James Morone is an American political scientist and author, noted for his work on health politics and policy and on popular participation and morality in American politics and political development.Morone graduated with a B.A...
said that despite Democrats denying the charge and focusing on the facts, the term played a role in their loss of control over the public debate because they did not address the "underlying fears of big government". Morone called the "death panel" arguments "pungent, memorable, simple, and effective." Journalist Paul Waldman of The American Prospect
The American Prospect
The American Prospect is a monthly American political magazine dedicated to American liberalism. Based in Washington, DC, The American Prospect is a journal "of liberal ideas, committed to a just society, an enriched democracy, and effective liberal politics" which focuses on United States politics...
, characterized the charge as a consequential policy lie, a falsehood that is not as condemned in media as an inconsequential personal lie.
Fox News analyst Juan Williams
Juan Williams
Juan Williams is an American journalist and political analyst for Fox News Channel, he was born in Panama on April 10, 1954. He also writes for several newspapers including The Washington Post, The New York Times, and The Wall Street Journal and has been published in magazines such as The Atlantic...
said "of course there is no such thing as any death panel." Gail Wilensky
Gail Wilensky
Gail R. Wilensky is an American health economist who has worked for Republican administrations and candidacies. Wilensky headed Medicare under the first president Bush and works at Project HOPE.-External links:**...
, a health adviser to President George H.W. Bush and John McCain who has overseen Medicare and Medicaid, said the charge was untrue and upsetting, adding that "[t]here are serious questions that are associated with policy aspects of the health care reform bills that we're seeing ... And there's frustration because so much of the discussion is around issues like the death panels and [Ezekiel Emanuel] that I think are red herring
Red herring
A red herring is a deliberate attempt to divert attention.Red herring may refer to:* Red herring , the informal fallacy of presenting an argument that may in itself be valid, but does not address the issue in question....
s at best." Susan Dentzer
Susan Dentzer
Susan Dentzer is the editor-in-chief of the academic journal Health Affairs. She is a member of the Institute of Medicine and the Council on Foreign Relations, the former health correspondent for the News Hour with Jim Lehrer, and a fellow at the Hastings Center. She is a graduate of Dartmouth...
, editor of Health Affairs
Health Affairs
Health Affairs is a peer-reviewed healthcare journal established in 1981 by John K. Iglehart. It was described by The Washington Post as "the bible of health policy". Health Affairs is indexed and/or abstracted in PubMed, MEDLINE, EBSCO databases, ProQuest, LexisNexis, Current Contents/Health...
, said Congress' approval of $1.1 billion for comparative effectiveness research
Comparative Effectiveness
Comparative effectiveness research is the direct comparison of existing health care interventions to determine which work best for which patients and which pose the greatest benefits and harms...
in the 2009 stimulus contributed to fear the research would "lead to government rationing" which "fueled the 'death panels' fury of summer 2009." The British paper, The Daily Telegraph
The Daily Telegraph
The Daily Telegraph is a daily morning broadsheet newspaper distributed throughout the United Kingdom and internationally. The newspaper was founded by Arthur B...
noted that some critics of the US reform used the United Kingdom's National Institute for Health and Clinical Excellence
National Institute for Health and Clinical Excellence
The National Institute for Health and Clinical Excellence is a special health authority of the English National Health Service , serving both English NHS and the Welsh NHS...
(NICE)—which, as one of its functions, uses cost-effectiveness analysis (CEA) to determine whether new treatments and drugs should be available to those covered by the National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
(NHS)—"as an example of the sort of drug rationing that amounted to a 'death panel'." The Sunday Times
The Sunday Times
The Sunday Times is a British Sunday newspaper.The Sunday Times may also refer to:*The Sunday Times *The Sunday Times *The Sunday Times *The Sunday Times...
, another British paper, wrote that Sarah Palin's use of the "death panels" term was a reference to NICE.
Physicians
C. Porter Storey Jr. thinks the term represents fear that due to financial pressure "some mechanical, governmental method will be used to determine how much of our scarce health care resources will be applied to their situation." Atul GawandeAtul Gawande
Atul Gawande is an American physician and journalist. He serves as a general and endocrine surgeon at Brigham and Women's Hospital in Boston, Massachusetts and associate director of their Center for Surgery and Public Health...
, a surgeon and writer, agrees that fear of missing out on an expensive life-extending treatment is behind the phrase, but he thinks framing the issue in this way completely misplaced. Gawande says "the trouble is not whether we're going to offer a $100,000 drug to help someone get 3 or 4 months"; our big trouble is that patients receive a $100,000 drug that not only yields no benefit—it also causes major side effects that shortens their lives. He said medicine has not "gotten good at making sure we are able to help people with their goals and decisions" without hurting people. Gawande said doctor's schedules—of 20 minute appointments back to back—and a lack of payments were barriers to these hour long discussions, as is the emotional difficulty in conversations that require patients to acknowledge their mortality. Geriatric psychiatrist Paul Kettl
Paul Kettl
Paul Kettl is an American geriatric psychiatrist. He worked as the former chair of psychiatry at the Pennsylvania State University College of Medicine...
said his experience in a geriatric unit showed end-of-life discussions and reimbursements were "desperately needed" as these hour long conversations are "ignored in the crush of medication and disease management."
The American Society of Clinical Oncology
American Society of Clinical Oncology
The American Society of Clinical Oncology is the world's leading professional organization representing physicians of all oncology subspecialties who care for people with cancer. Founded in 1964 by Drs...
published a statement in January 2011 advocating an individualized approach to treatment and supportive care for patients with advanced cancer and said that the issue of compensating physicians for discussing options with patients had been "unfortunately politicized", and should be revisited because "these efforts had at their core a critical patient-centered societal interest".}}
In the Journal of the American Medical Association
Journal of the American Medical Association
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...
, Kettl wrote "I wish we had death panels. I don't mean that I'm in favor of some appointed group of erudite experts gathering to decide who lives or dies in a process controlled by the government, but rather the death panels that were originally proposed. I'm in favor of periodic discussions about advance directives that Medicare would pay for as medical visits." Kettl noted that the attention-catching phrase "death panels" became "a lightning rod for objections to a series of ideas about health care besides" end-of-life discussions, and that somehow, "the concept of physicians being paid for time to talk with patients and their families about advance directives ... generated into the fear of decisions about life and death being controlled by the government." Kettl wrote that "Emotions and health care go together. That makes them an easy and consistent target for the media and for grandstanding commentators. We can expect more good medical ideas to be destroyed by sound bytes and needless concerns that will be exaggerated. It makes for good television, but bad medicine."
Benjamin W. Corn, a cancer specialist, wrote in the New England Journal of Medicine
New England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...
that the "death panels" controversy showed Americans were uneasy discussing topics related to the dying process. Corn supports the end-of-life care conversations, as he says that they can have an important positive effect on patients. Corn offered suggestions on how to present to conversations to patients, but he said some patients may not ever welcome them. Corn thinks certain issues, such as whether experimental therapies should be reimbursed, the possible expansion of hospices, restoring dignity to the process of dying, and guidelines for physician assisted suicide, need to be addressed directly.
Politicians
Sen. Lisa MurkowskiLisa Murkowski
Lisa Ann Murkowski is the senior U.S. Senator from the State of Alaska and a member of the Republican Party. She was appointed to the Senate in 2002 by her father, Governor Frank Murkowski. After losing a Republican primary in 2010, she became the second person ever to win a U.S...
(R-AK) stated that "death panels" were a baseless charge that unnecessarily incited fear and detracted from real problems in the proposed legislation. She said it was "bad enough that we don't need to be making things up". Sen. Johnny Isakson
Johnny Isakson
John Hardy "Johnny" Isakson is the junior United States Senator from Georgia and a member of the Republican Party. Previously, he represented in the House....
(R-GA), thought there was illogical confusion over "death panels"; he said advance directives put "authority in the individual rather than the government." In July 2010 Rep. Bob Inglis
Bob Inglis
Robert Durden "Bob" Inglis, Sr. is a former U.S. Representative for , serving from 1993 to 1999, and then again from 2005 until 2011. He is a member of the Republican Party...
, (R-SC) said that he thought it was counterproductive for the conservative movement for some to promote misinformation about death panels when they do not exist. Rep. Darrell Issa
Darrell Issa
Darrell Edward Issa is the U.S. Representative for , and previously the 48th, serving since 2001. He is a member of the Republican Party. He was formerly a CEO of Directed Electronics, the Vista, California-based manufacturer of automobile security and convenience products...
(R-CA) said that he agrees with his colleague, Rep. Charles Boustany
Charles Boustany
Charles William Boustany, Jr. is the U.S. Representative for , serving since 2005. He is a member of the Republican Party.-Early life, education, and medical career:...
(R-LA), a surgeon. As quoted in The Wall Street Journal
The Wall Street Journal
The Wall Street Journal is an American English-language international daily newspaper. It is published in New York City by Dow Jones & Company, a division of News Corporation, along with the Asian and European editions of the Journal....
, Issa, referencing Boustany, said "medical panels of people who care about what's best for their patients ... is good science and good medicine." Speaking for himself, Issa said "Republicans have to step back from the words 'death panels'."
Rep. Earl Blumenauer
Earl Blumenauer
Earl Blumenauer is the U.S. Representative for , serving since 1996. He is a member of the Democratic Party. The district includes most of Portland east of the Willamette River. A native of Portland, he previously spent over 20 years as a public official representing the city.-Early...
(D-OR) called the references to "death panels" or euthanasia "mind-numbing" and "a terrible falsehood". He thought that the news media contributed to the persistence of the myth by amplifying misinformation and extreme behavior. When a regulation for reimbursing consultation payments was upcoming, Blumenauer cautioned supporters to keep things quiet, reasoning that Republican leaders would attempt to continue the myth. President Barack Obama cited the charge—along with the citizenship conspiracy theories
Barack Obama citizenship conspiracy theories
Conspiracy theories about the citizenship of Barack Obama claim that Barack Obama is not a natural-born citizen of the United States and is therefore not eligible to be President of the United States under Article Two of the U.S. Constitution. Some theories allege that Obama was born in Kenya, not...
and "job-killing" allegations—as demagogy
Demagogy
Demagogy or demagoguery is a strategy for gaining political power by appealing to the prejudices, emotions, fears, vanities and expectations of the public—typically via impassioned rhetoric and propaganda, and often using nationalist, populist or religious themes...
against him. In testimony to the United States Congress Joint Select Committee on Deficit Reduction
United States Congress Joint Select Committee on Deficit Reduction
The Joint Select Committee on Deficit Reduction, colloquially referred to as the Supercommittee, is a joint select committee of the United States Congress, created by the Budget Control Act of 2011 on August 2, 2011...
, Erskine Bowles
Erskine Bowles
Erskine Boyce Bowles is an American businessman and political figure from North Carolina. He served from 2005 to 2010 as the President of the University of North Carolina system...
(D), co-chair of the National Commission on Fiscal Responsibility and Reform
National Commission on Fiscal Responsibility and Reform
The National Commission on Fiscal Responsibility and Reform is a Presidential Commission created in 2010 by President Barack Obama to identify "…policies to improve the fiscal situation in the medium term and to achieve fiscal sustainability over the long run."...
, called "death panels" "a kind of crazy stuff" and added that end-of-life care in the U.S. needed reform.
Palin reaction
On August 12, five days after her initial Facebook note, Palin posted another, defending her debunked charge. She charged that "the elderly and ailing would be coerced into accepting minimal end-of-life care to reduce health care costs" so it was misleading for Obama to say the sessions would be entirely voluntary. PolitiFact responded that Palin's assertion was false and that the sessions were voluntary. On August 12 she also charged on Twitter that Britain's NHS was an evil "death panel", leading to so many replies from British citizens defending the NHS that Twitter crashed. Disabled professor Stephen HawkingStephen Hawking
Stephen William Hawking, CH, CBE, FRS, FRSA is an English theoretical physicist and cosmologist, whose scientific books and public appearances have made him an academic celebrity...
led the responses, saying "I wouldn't be alive today if it weren't for the NHS."
In a September 2009 speech in Hong Kong, Palin said the term was "intended to sound a warning about the rationing that is sure to follow if big government tries to simultaneously increase health care coverage while also claiming to decrease costs." In November 2009 Palin said that Obama was "incorrect" and "disingenuous" when he called the "death panel" charge "a lie, plain and simple." In the National Review
National Review
National Review is a biweekly magazine founded by the late author William F. Buckley, Jr., in 1955 and based in New York City. It describes itself as "America's most widely read and influential magazine and web site for conservative news, commentary, and opinion."Although the print version of the...
she said
"[t]o me, while reading that section of the bill, it became so evident that there would be a panel of bureaucrats who would decide on levels of health care, decide on those who are worthy or not worthy of receiving some government-controlled coverage ... Since health care would have to be rationed if it were promised to everyone, it would therefore lead to harm for many individuals not able to receive the government care. That leads, of course, to death."
She explained that the term should not be taken literally, likening it to when President Ronald Reagan
Ronald Reagan
Ronald Wilson Reagan was the 40th President of the United States , the 33rd Governor of California and, prior to that, a radio, film and television actor....
called the Soviet Union, the "Evil Empire
Evil empire
The phrase evil empire was applied to the Soviet Union especially by U.S. President Ronald Reagan, who took an aggressive, hard-line stance that favored matching and exceeding the Soviet Union's strategic and global military capabilities, in calling for a rollback strategy that would, in his words,...
." "He got his point across. He got people thinking and researching what he was talking about. It was quite effective. Same thing with the 'death panels'. I would characterize them like that again, in a heartbeat", she said. Media Matters
Media Matters
Media Matters can refer to:* Media Matters for America, progressive media watchdog group founded by author David Brock* The radio program Media Matters hosted by communications professor Robert W. McChesney...
stated that "Palin's claim of 'death panels' bureaucrats deciding who is 'worthy of health care' is simply false, regardless of whether she meant it literally or figuratively."
In December 2009 Palin warned on Twitter that a merged health care bill could have the "death panels" restored. In October 2010, Palin defended her use of the term in a Newsmax.com interview. Palin said she
"... spoke a lot about the rationing of care that was going to be a part of Obamacare, and, you know, I was about laughed out of town for bringing to light what I call death panels, because there's going to be faceless bureaucrats who will—based on cost analysis and some subjective idea on somebody's level of productivity in life—somebody is going to call the shots as to whether your loved one will be able to receive health care or not. To me, death panel. I called it like I saw it, and people didn't like it."
Palin used the term in a joke while speaking at the 2009 Gridiron Club
Gridiron Club
The Gridiron Club and Foundation, founded in 1885, is the oldest and one of the most prestigious journalistic organizations in Washington, D.C. Its 65 active members represent major newspapers, news services, news magazines and broadcast networks. Membership is by invitation only and has...
dinner, saying "It is good to be here and in front of this audience of leading journalists and intellectuals. Or, as I call it, a death panel."
Political
Consultation payments were removed from the Senate version of the bill by the Senate Finance Committee. TIME wrote that "a single phrase—'death panels'—nearly derailed health care reform". The Washington Post wrote that "President Obama's health-care initiative was nearly consumed by the furor" over the end-of-life care provision that would allow physician reimbursement for counseling.By mid-August 2009, about a week after Palin's initial Facebook note, the Pew Research Center
Pew Research Center
The Pew Research Center is an American think tank organization based in Washington, D.C. that provides information on issues, attitudes and trends shaping the United States and the world. The Center and its projects receive funding from The Pew Charitable Trusts. In 1990, Donald S...
reported that 86% of Americans had heard of the "death panels" charge. Out of those who had heard the charge, 30% of people thought it was true while 20% did not know. For Republicans, 47% thought it was true while 23% did not know. Oberlander said the false warnings of a government takeover and "death panels" from Republicans drowned out the "Democrats' focus group–tested mantra of 'quality, affordable health care' ". Morone said the White House was not able to offer a "persuasive narrative to counter the Tea Party percussion", and "struggled to recapture public attention", contributing to Republican Scott Brown
Scott Brown
Scott Brown is a United States senator.Scott Brown may also refer to:-Sportsmen:*Scott Brown , American college football coach of Kentucky State...
's election. The election of Brown in the special Senate election in Massachusetts
United States Senate special election in Massachusetts, 2010
The 2010 United States Senate special election in Massachusetts was a special election held on January 19, 2010, in order to fill the Massachusetts Class I United States Senate seat for the remainder of the term ending January 3, 2013...
was a surprise victory for Republicans and a setback for the chance of health care reform under Democratic leadership; Brown won the historical Senate seat of the late Democrat Ted Kennedy
Ted Kennedy
Edward Moore "Ted" Kennedy was a United States Senator from Massachusetts and a member of the Democratic Party. Serving almost 47 years, he was the second most senior member of the Senate when he died and is the fourth-longest-serving senator in United States history...
, ending the Democrat's supermajority
Supermajority
A supermajority or a qualified majority is a requirement for a proposal to gain a specified level or type of support which exceeds a simple majority . In some jurisdictions, for example, parliamentary procedure requires that any action that may alter the rights of the minority has a supermajority...
of 60 in the Senate.
In September 2010, six months after the passage of the Affordable Care Act, a BBC
BBC
The British Broadcasting Corporation is a British public service broadcaster. Its headquarters is at Broadcasting House in the City of Westminster, London. It is the largest broadcaster in the world, with about 23,000 staff...
article stated that among the "sticky charges" that had stuck against the bill was the false charge of "government 'death panels' deciding who can get what sort of care". A survey by the Regence Foundation and National Journal
National Journal
National Journal is a nonpartisan American weekly magazine that reports on the current political environment and emerging political and policy trends. National Journal was first published in 1969. Times Mirror owned the magazine from 1986 to 1997, when it was purchased by David G. Bradley...
released in 2011 showed 40% of Americans knew that the "death panels" were not in the Affordable Care Act, while 23% said they thought the law allowed government to make end-of-life care decisions on behalf of seniors, and 36% said they did not know. Other findings from the survey included:
- 78% thought palliative care and end-of-life issues should be in the public discourse;
- 93% thought those decisions should be a top priority in the US health care system;
- 70% agreed with the idea that "It is more important to enhance the quality of life for seriously ill patients, even if it means a shorter life" while 23% placed more importance on extending life through any possible medical treatment;
- Doctors, family, and friends were highly trusted sources for end-of-life care information while only 33% trusted elected officials or political candidates for accurate information.
Social
Atul GawandeAtul Gawande
Atul Gawande is an American physician and journalist. He serves as a general and endocrine surgeon at Brigham and Women's Hospital in Boston, Massachusetts and associate director of their Center for Surgery and Public Health...
, a physician who writes on health care topics for The New Yorker
The New Yorker
The New Yorker is an American magazine of reportage, commentary, criticism, essays, fiction, satire, cartoons and poetry published by Condé Nast...
, said "that the whole death panel reduction and reaction to it" temporarily "shut down our ability to even have a national discussion about how to have the right [end-of-life] conversation" between doctors and patients.
When investigating for his article "Letting Go", Gawande was asked to refrain from writing about palliative care
Palliative care
Palliative care is a specialized area of healthcare that focuses on relieving and preventing the suffering of patients...
by physicians who were concerned the article might be manipulated to create another political controversy—and as a result, hurt their profession. Professor Harold Pollack
Harold Pollack
Harold Pollack is an American professor at the University of Chicago who has been appointed to two Institute of Medicine committees. His research has focused on public health and health policy. At the University of Chicago, he has chaired the Center for Health Administration Studies...
wrote that given the "anxieties captured in the crystalline phrase 'death panel,' I would not commence a national cost-control discussion within the frightening and divisive arena of end-of-life care."
Bishop et al. were fearful of how their publication on CPR/DNR
Do not resuscitate
In medicine, a "do not resuscitate" or "DNR" is a legal order written either in the hospital or on a legal form to respect the wishes of a patient to not undergo CPR or advanced cardiac life support if their heart were to stop or they were to stop breathing...
would be received by the medical and bioethics communities. They were concerned because in "the era of rhetoric centered on fictional 'death panels' " their paper addressed "the quest for immortality implicit in US culture, a culture of 'life-at-all costs' that medical technology has advanced". Bishop et al. interpreted cautioning comments from their peers as a suggestion "that land mines of 'death panels' await us".
PolitiFact.com
PolitiFact.com
PolitiFact.com is a project that is operated by the St. Petersburg Times, a project in which its reporters and editors "fact-check statements by members of Congress, the White House, lobbyists and interest groups...." They publish original statements and their evaluations on the PolitiFact.com...
gave Palin's claim its lowest rating—"Pants on Fire!"—on August 10 and on December 19 it was named "Lie of the Year" for 2009. "Death panel" was named the most outrageous term of 2009 by the American Dialect Society
American Dialect Society
The American Dialect Society, founded in 1889, is a learned society "dedicated to the study of the English language in North America, and of other languages, or dialects of other languages, influencing it or influenced by it." The Society publishes the academic journal, American Speech...
. The definition was given as "A supposed committee of doctors and/or bureaucrats who would decide which patients were allowed to receive treatment, ostensibly leaving the rest to die". FactCheck
FactCheck
FactCheck.org is a non-partisan, nonprofit website that describes itself as a consumer advocate' for voters that aims to reduce the level of deception and confusion in U.S. politics." It is a project of the Annenberg Public Policy Center of the Annenberg School for Communication at the University...
called it one of the "whoppers" of 2009.
Media analysis
Megan Garber of the Columbia Journalism ReviewColumbia Journalism Review
The Columbia Journalism Review is an American magazine for professional journalists published bimonthly by the Columbia University Graduate School of Journalism since 1961....
called the topic "irresistable" to reporters because it covered conflict, drama, innuendo, and Sarah Palin. Garber said it was "notoriously challenging for the press to deal with" because the old method of deligitmization—ignoring—was no longer workable. "Debunking rumors without simultaneously sanctioning them has always been a fraught endeavor, with the proliferation of niche media sites over the past several years only rendering that effort even more precarious," said Garber.
A study by Regina G. Lawrence, a communications professor, and Matthew L. Schafer, a Juris Doctor
Juris Doctor
Juris Doctor is a professional doctorate and first professional graduate degree in law.The degree was first awarded by Harvard University in the United States in the late 19th century and was created as a modern version of the old European doctor of law degree Juris Doctor (see etymology and...
candidate, found that "the mainstream news, particularly newspapers, debunked 'death panels' early, fairly often, and in a variety of ways, though some were more direct than others." Of the journalists that reported the charge as false, 30% presented information in a he said/she said style, often confusing readers. Of the reports that presented "death panels" as false, 75% did not include an explanation. Lawrence and Schafer said that "the dilemma for reporters playing by the rules of procedural objectivity is that repeating a claim reinforces a sense of its validity—or at least, enshrines its place as an important topic of public debate. Moreover, there is no clear evidence that journalism can correct misinformation once it has been widely publicized. Indeed, it didn't seem to correct the death panels misinformation in our study."
Brendan Nyhan concluded his study on the "death panel" myth with two recommendations to improve future media performance.
"... [U]ntil the media stops giving so much attention to misinformers, elites on both sides will often succeed in creating misperceptions, especially among sympathetic partisans. And once such beliefs take hold, few good options exist to counter them—correcting misperceptions is simply too difficult. The most effective approach may therefore be for concerned scholars, citizens, and journalists to (a) create negative publicity for the elites who are promoting misinformation, increasing the costs of making false claims in the public sphere, and (b) pressure the media to stop providing coverage to serial dissemblers."
Continued use
In response to legislation in ArizonaArizona
Arizona ; is a state located in the southwestern region of the United States. It is also part of the western United States and the mountain west. The capital and largest city is Phoenix...
which cut Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
funding for previously approved transplants, E.J. Montini of The Arizona Republic
The Arizona Republic
The Arizona Republic is a daily newspaper published in Phoenix. Circulated throughout Arizona, it is the state's largest newspaper. Since 2000, it has been owned by the Gannett newspaper chain. It was ranked tenth in US daily newspapers by circulation in 2007.-Early years:The newspaper was founded...
used the term, as did Keith Olbermann
Keith Olbermann
Keith Theodore Olbermann is an American political commentator and writer. He has been the chief news officer of the Current TV network and the host of Current TV's weeknight political commentary program, Countdown with Keith Olbermann, since June 20, 2011...
of MSNBC
MSNBC
MSNBC is a cable news channel based in the United States available in the US, Germany , South Africa, the Middle East and Canada...
. Montini referred to Republican Governor Jan Brewer
Jan Brewer
Janice Kay "Jan" Brewer is the 22nd and current Governor of the U.S. state of Arizona and a member of the Republican Party. She is the fourth woman, and third consecutive woman, to hold the office...
as "Governor Grim Reaper" and both Brewer and the Republican-controlled legislature as a "death panel". An editorial by USA Today
USA Today
USA Today is a national American daily newspaper published by the Gannett Company. It was founded by Al Neuharth. The newspaper vies with The Wall Street Journal for the position of having the widest circulation of any newspaper in the United States, something it previously held since 2003...
said, "to the extent that death panels of a sort do exist, they're composed of state officials who must decide whether each state's version of Medicaid will cover certain expensive, potentially life-saving treatments."
Palin applied the term to the IPAB. After the National Commission on Fiscal Responsibility and Reform
National Commission on Fiscal Responsibility and Reform
The National Commission on Fiscal Responsibility and Reform is a Presidential Commission created in 2010 by President Barack Obama to identify "…policies to improve the fiscal situation in the medium term and to achieve fiscal sustainability over the long run."...
released its recommendation to strengthen the IPAB, she charged in the Wall Street Journal that the board was " 'death panel'-like". FactCheck
FactCheck
FactCheck.org is a non-partisan, nonprofit website that describes itself as a consumer advocate' for voters that aims to reduce the level of deception and confusion in U.S. politics." It is a project of the Annenberg Public Policy Center of the Annenberg School for Communication at the University...
found her characterization of the board wrong on three counts. Representative Phil Roe
Phil Roe
David Phillip "Phil" Roe is the U.S. Representative for , serving since 2009. He is a member of the Republican Party. The district is based in the Tri-Cities area in the northeastern portion of the state....
(Republican-Tennessee), who has twice sponsored bills to eliminate the IPAB, said he would associate the term with the IPAB. Roe was described by the The Washington Post
The Washington Post
The Washington Post is Washington, D.C.'s largest newspaper and its oldest still-existing paper, founded in 1877. Located in the capital of the United States, The Post has a particular emphasis on national politics. D.C., Maryland, and Virginia editions are printed for daily circulation...
as "a kindred soul by the medical industry" in part for his legislative efforts against the IPAB and a "magnet during the last election for more than $90,000 in contributions from medical professionals from across the country". Rep. Phil Gingrey
Phil Gingrey
John Phillip "Phil" Gingrey, is the U.S. Representative for , serving since 2003. He is a member of the Republican Party. The district is located in the northwestern suburbs of Atlanta.-Early life, education and career:...
(Republican-Georgia), an OB/GYN, issued a factually inaccurate statement, described by PolitiFact as outrageous, that was in line with the "death panels" narrative.
In October 2010, The Philadelphia Inquirer
The Philadelphia Inquirer
The Philadelphia Inquirer is a morning daily newspaper that serves the Philadelphia, Pennsylvania, metropolitan area of the United States. The newspaper was founded by John R. Walker and John Norvell in June 1829 as The Pennsylvania Inquirer and is the third-oldest surviving daily newspaper in the...
highlighted the term in its "The Week in Words" article after Barney Frank
Barney Frank
Barney Frank is the U.S. Representative for . A member of the Democratic Party, he is the former chairman of the House Financial Services Committee and is considered the most prominent gay politician in the United States.Born and raised in New Jersey, Frank graduated from Harvard College and...
said the only "death panels" created by congressional Democrats were for troubled financial institutions under the authority of the Dodd–Frank Bill.
In November 2010, Paul Krugman
Paul Krugman
Paul Robin Krugman is an American economist, professor of Economics and International Affairs at the Woodrow Wilson School of Public and International Affairs at Princeton University, Centenary Professor at the London School of Economics, and an op-ed columnist for The New York Times...
was deliberately provocative on This Week, calling for "death panels and sales taxes" to fix the budget deficit
United States public debt
The United States public debt is the money borrowed by the federal government of the United States at any one time through the issue of securities by the Treasury and other federal government agencies...
. Krugman clarified that "health care costs will have to be controlled, which will surely require having Medicare and Medicaid decide what they’re willing to pay for—not really death panels, of course, but consideration of medical effectiveness and, at some point, how much we’re willing to spend for extreme care."
In his 2011 book, Mike Huckabee claimed that the Federal Coordinating Council for Comparative Effectiveness from the 2009 stimulus were the seeds from which "the poisonous tree of death panels will grow." Media Matters called this a "lie"; it reported that Huckabee mischaracterized the council and that it was eliminated in the 2010 health care reform. Paul Van de Water of the Center on Budget and Policy Priorities
Center on Budget and Policy Priorities
The Center on Budget and Policy Priorities is a non-profit think tank that describes itself as a "policy organization ... working at the federal and state levels on fiscal policy and public programs that affect low- and moderate-income families and individuals."The Center examines the short- and...
, said "Huckabee seems to be suggesting that we shouldn't do research to find out what medical procedures work best just because that research could conceivably be misused. The new law makes every effort to assure that won't happen."
See also
- Politicization of sciencePoliticization of scienceThe politicization of science is the manipulation of science for political gain. It occurs when government, business, or advocacy groups use legal or economic pressure to influence the findings of scientific research or the way it is disseminated, reported or interpreted. The politicization of...
- Lyndon LaRouche on the subject
External links
- A History Of Death Panels: A Timeline Media MattersMedia MattersMedia Matters can refer to:* Media Matters for America, progressive media watchdog group founded by author David Brock* The radio program Media Matters hosted by communications professor Robert W. McChesney...
March 22, 2011. - Economix blog postings tagged with the term from the The New York Times
- News and Video from Fox News
- Betsy McCaughey on The Daily ShowThe Daily ShowThe Daily Show , is an American late night satirical television program airing each Monday through Thursday on Comedy Central. The half-hour long show premiered on July 21, 1996, and was hosted by Craig Kilborn until December 1998...
parts 1 and 2 and extended interviews parts 1 and 2 - Dr. Atul Gawande: Return of the "Death Panel Myth" is a Travesty – video report by Democracy Now!Democracy Now!Democracy Now! and its staff have received several journalism awards, including the Gracie Award from American Women in Radio & Television; the George Polk Award for its 1998 radio documentary Drilling and Killing: Chevron and Nigeria's Oil Dictatorship, on the Chevron Corporation and the deaths of...
- Will Wilkinson (August 26, 2009). "Death Panels: Wrong Name, Right Idea" Cato InstituteCato InstituteThe Cato Institute is a libertarian think tank headquartered in Washington, D.C. It was founded in 1977 by Edward H. Crane, who remains president and CEO, and Charles Koch, chairman of the board and chief executive officer of the conglomerate Koch Industries, Inc., the largest privately held...
Accessed August 3, 2011. - Articles in the April 2011 issue of Virtual Mentor by Wong, Frick, and Fleck