Today’s POV blog

The U.S. Preventive Services Task Force (USPSTF) is an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services. In layman’s terms, this group reviews and gives advice to you and me about health services and healthy living.

The USPSTF makes recommendations on all sorts of topics — everything from alcohol misuse to cancer, from heart disease to Alzheimer’s, and from exercise to STDs. Last month, the USPSTF announced that the organization no longer recommends that women begin mammogram screening at 40, but rather that they delay until the age of 50.

As benign as this may seem at first blush, Republicans, such as Rep. Marsha Blackburn, are leveling accusations and intimating that this “medical rationing.” The concern is that this type of rationing will be commonplace under the new healthcare reform.

In support of the USPSTF’s recommendations and according to GlobalHealingCenter.org, while mammograms do help detect some breast abnormalities, they might actually be increasing the occurrence of breast cancer. Recent research has shown that repeated exposure to mammograms may act as an independent risk factor for breast cancer.

At the center of this concern is the amount of radiation to which the patient is exposed during her annual mammogram. A typical x-ray exposes the patient to 1 rad and each rad is believed to increase the breast-cancer risk by 1%. By starting annual mammograms at 40, the patient is exposed to an addition 10% risk.

In a story reported by Time, the USPSTF is surprised at all the political hoopla. According to member Dr. Diana Petitti, an Arizona State University professor and vice chair of the task force, “Our attempt to communicate [the risks and benefits of] routine screening was definitely lost.”

In an effort to restrict tax credits used to pay for abortions, Senator Max Baucus (D, Montana) has penned a bill that has further delayed the progress of the health-care reform bill before congress. The abortion bill would allow exceptions only in the case of rape or incest or if the life of a pregnant woman were in danger.

Senator Orrin Hatch (R, Utah), proposed even stricter provisions that would deny any money provided under the legislation could be used to cover “any part of the costs of any health plan that includes coverage of abortion.” Hatch’s version allowed almost no exceptions.

The proposal has been rejected by the Senate Finance Committee according to NYTimes.com; the 13-10 vote followed party lines with descending votes coming only from Senator Conrad (D, North Dakota) and Senator Snowe (R, Maine).

The bill proposes that health plans and abortion coverage would differ, but that private insurance plans permitting the coverage of abortion would be required to segregate money — taken from private premiums — to cover the procedure. Insured individuals could opt for a separate supplemental policy that would cover abortions, but that individuals would be responsible for opting for and paying the supplemental insurance offering such coverage.

Six months after Washington passed a law to permit assisted suicides, nearly a dozen people have ended their lives according to a story at USA Today online. Considering that this accounts for one-tenth of 1% of Washinton’s 2008 deaths, it’s obvious that the concern some have had about the possibility of alarming numbers is unfounded.

At AssistedSuicide.org, Derek Humphry takes on the question about vernacular, in his article titled “What do you call an assisted death?”

In Oregon, specifically, there is discourse between those in favor, but who dislike terms such as suicide, euthanasia, and Hemlock, and those against who are in need of defined terms that they purport will clarify the situations and remedies. The Oregon Department of Human Services (DHS) settled on the term physician-assisted suicide and that has been widely accepted for law and articles on the topic. Some consternation occurs when the media uses the terms suicide or assisted suicide because the terms do not make it clear that only licensed doctors may prescribe the medications for early termination.

Washington and Oregon are the only two states with voter-approved assisted suicide laws.

Compassionandchoices.org provides information on how the new health-care reform is expected to affect assisted suicides. House resolution 3200, Section 1233, would allow doctors to bill Medicare for end-of-life conversations. According to this site, patients who have spoken with their doctors about end-of-life options were left with significantly lower health-care costs in their final week of life.

In a BBC story earlier this month, it is reported that Montana’s Supreme Court will begin hearing arguments to determine if their severely or terminal ill residents have a right to the same physician-assisted termination now granted to Washington residents. In an earlier ruling, the right to assisted suicide was granted, but the state of Montana is trying to reverse that decision.

Dr. Jack Kevorkian, likely the most famous and most staunch supporter of assisted suicide spent eight years in prison for having the courage of his convictions — in spite of the laws — and participating in at least 130 suicides, according to a June 2007 article at MSNBC online.

Obviously every situation will be different and there are many pros and cons to weigh. We might feel differently if deciding for ourselves than when deciding for our comatose and brain-damaged child. Is this a personal decision, or should it be legislated? You choose.