Bioethics Blogs


by Ellen Fox, MD

It’s been five years since the media firestorm around “death panels” – a term coined by Sarah Palin to refer to a provision in Obamacare that would have authorized Medicare payments for advance care planning discussions. Though the initial blaze died down quickly, the fire has continued to smolder (as shown in this graph I generated using “Google Trends”). The long-term fallout from death panels has been profound, and has extended far beyond issues of Medicare reimbursement.

In my former role as director of the National Center for Ethics in Health Care within the U.S. Department Veterans Affairs (VA) health care system, I experienced the heat of the “death panel” conflagration firsthand when, in 2009, an advance care planning workbook that had been developed at the Seattle VA hospital in the mid 1990’s became “a lightning rod in the health care debate.”

At the time the media frenzy erupted, we were already overhauling the outdated workbook for national distribution. Due to the unwanted media attention, however, the revision process became even more complex and challenging. After seemingly endless rounds of stakeholder input and review, we were finally ready to release a new and revamped product. It was called Planning for Future Health Care Decisions…My Way (or Planning My Way for short).

But alas, the death panel problem had made Planning My Way a political hot potato. We tried numerous times and tactics to gain approval to release Planning My Way, all to no avail.

As time passed I grew increasingly concerned about the delay.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.