I must confess to having had some misgivings about the uproar over Section 1233 of the proposed health care reform bill HR 3200. This section pertains to government payment for counseling on end-of-life options under Obamacare. From Sarah Palin’s ‘death panels” to an endless host of hyperbolic rhetoric about how this counseling is “mandatory” (it’s not) and will inevitably lead to euthanasia, I have felt that much of the discourse is over the top and poorly supported by the text of the bill, and may well prove counterproductive in the long run.

This is not to say that there is no reason for concern: the enormous financial strains which the proposed legislation will place on the health care system, combined with a government panel to decide the “appropriateness” of medical care, certainly introduces significant moral hazards in creating pressures to restrict expensive care at the end of life. Given the growing legality of physician assisted suicide (PAS) — first legalized in Oregon and most recently in Washington, with many other states considering it legislatively or by fiat from judges — it is likely that PAS will become one of the options which must be discussed as part of such end of life counseling, and that there will be pressure to use such “cost-effective” options. Oregon is now offering coverage for PAS while denying expensive palliative chemotherapy. It is not hard to imagine such a trend developing at the federal level as well.

But despite my reservations about the current political firestorm on this issue, there may well be more cause for concern than I have previously believed: via the invaluable Second Hand Smoke, Wesley Smith picks up an interesting trail: the organization Compassion and Choices was deeply involved in helping to craft this section of HR 3200.

So who exactly are these folks? Does the name “Hemlock Society” ring a bell, per chance?

The Hemlock Society was founded by Derek Humphry in 1980, a rabid proponent of assisted suicide and euthanasia, as he himself makes clear:

Born in 1980 in my garage in Santa Monica, California, Hemlock went on to be the largest and oldest right-to-die organization in America fighting for voluntary euthanasia and physician-assisted suicide to be made legal for terminally and hopelessly ill adults.

But the name ultimately proved a little too close to the truth for comfort, and so eventually needed to be changed to something more anodyne: “We [also] need access to the halls of government in the states and in Washington DC – access that the name ‘Hemlock’ is currently denying us. The name Hemlock … is also baggage, baggage that we can no longer afford to have weighing us down or interfering with our being able to partner with such important and powerful organizations as AARP.” And so Hemlock joined other pro-death organizations in 2003 to become reincarnated as “Compassion and Choices.”

And now, clearly, they have the congressional access they sought. Ahh, the power of euphemism — what would a death cultist do without the words “choice” and “compassion”?

Compassion and Choices has become the shepherd and sole spokesmen of Oregon’s assisted suicide law — and were intimately involved in writing the Oregon legislation. They have been involved in over 75% of PAS cases in Oregon, and tightly control the media disclosures surrounding these suicides:

The group promoting assisted suicide, so-called “Compassion and Choices (C&C)”, are like the fox in the proverbial chicken coop; in this case the fox is reporting its version to the farmer regarding what is happening in the coop. Members of C&C authored and proclaim they are the stewards of Oregon’s assisted suicide law. They call it “their law”. They have arranged and participated in 3/4ths of Oregon’s assisted suicide cases. Their medical director reported she’d participated in more than 100 doctor-assisted suicides as of March 2005. A physician board-member reported in 2006 that he’d been involved with over forty such patients. Their executive director reported in September 2007 that he has attended more than 36 assisted suicide deaths. He has been involved in preparing the lethal solution. Yet, he is not a doctor.

Furthermore, there is no outside audit of PAS cases in Oregon; Neither Oregon’s Department of Health Services nor independent outside auditors may review them — and complications of the procedure are reported only by the prescribing physician, an obvious conflict of interest.

They have been involved in like manner in the PAS cases in Washington as well.

Hyperbole aside, there is plenty of reason for concern when government gets in the business of managing end of life decision making; assisted suicide will be a very tempting option when government desperately tries to reign in runaway costs for care of the elderly and dying.

And you can be sure if they implement these controls that groups like Compassion & Care will have a seat at the table.