An extraordinary look inside a 'death panel'
Sarah Palin's provocative reference to "death panels" last summer prompted paranoid fantasies about government health care and more excuses to delay the screaming need to control health costs. The Philadelphia Inquirer did what newspapers are supposed to do: It embedded itself on what some might imagine to be a death panel and wrote in great detail about what happened.
Reporter Michael Vitez spent months with a "palliative care" team at Abington Memorial Hospital and the Tole family as they agonized over what to do about 74-year-old Mary Tole, a mother, sister and grandmother who had fallen into sudden, mysterious and what seemed to be permanent dementia and decline. The family and health professionals allowed Vitez to be in the room as they made the tough decisions on whether to continue the administration of phenomenally expensive care for Mary Tole.
Yes, Vitez's presence probably subtly changed the story. The act of observing always alters what is observed, whether in quantum physics or journalism. Would people have acted differently had the reporter not been there? But the piece is an amazing, sensitive and complete picture of the terrible choices that must be made. I say "complete" because it contains what these kinds of stories almost never do -- the cost of the care. Treating Mary Tole cost Medicare and taxpayers more than $700,000. If you don't include the dollars, you haven't told the whole story.
Mary Tole's family, like most Americans, had no idea what a palliative care team was, or what the meeting would be about. The family had heard the noise all summer in the media over "death panels" and "pulling the plug on Grandma."
Was that what this was?
One brother, Greg Smith, 53, of Glenside, didn't want to go to any meeting that morning, but his wife pushed him. "They're going to pull the plug," he worried, "and everything's going to be over."
Another brother, Bob Smith, 64, of Douglassville, Pa., feared doctors had called the meeting "to plan her final days."
Diane Dietzen, medical director of the palliative care team at Abington, led Mary's two brothers, two daughters, and a sister-in-law away from the sterile ICU and into a family lounge, where they sat in a circle, on a sofa and comfy chairs, as if in somebody's living room.
Dietzen shut the door.