Mom and the Supreme Court

When the Supreme Court of the United States begins its three-day review of ObamaCare today, my mom won't be there.

I wish she could be there to present her case.  For she and millions of other elderly and vulnerable people will be affected in ways that seem unimaginable today if the court upholds the Patient Protection and Affordable Care Act.

For now, Mom is OK. 

Yes, she is dying -- but she is dying the way she wants to die, not the way someone else thinks she should die.

And that is part of what is at stake as the justices listen to arguments.

Mom's surgeon had been forthright with me, as I wished him to be.  Your mom's circulatory system is shutting down, he said.  That's why she has the gangrene in her leg.  We have tried a stent to save the limb, but after an hour and a half, we just couldn't get through the blockages in the vein.

"So what are her options now?" I asked, putting aside with great effort the image of my post-operative mom with her gray-white face, her limbs a garish reddish purple, the veins and capillaries bursting under the frail, taut skin like little bloody creeks.

He continued in his technical and clinical way.  She had three options.  She could choose to have an elaborate operation to replace the veins with healthy ones -- no guarantee of success at her age; she could choose to have her leg amputated above the knee -- the right leg was going, too; or she could choose to let nature take its course and opt for hospice care until death occurred.

I looked at him.  He appeared thin, harried and overworked.  His eyes had bluish circles under them, and his fine-boned surgeon's hands seemed to tremble slightly as he gesticulated. 

"Mom would never opt for amputation," I said.  "It would kill her."

"Oh, no," he said.  "She would most likely survive and heal."

"No," I said.  "She won't.  What I am saying is that amputation would kill Mom as we children and her friends know her.  It would be the end of the person we know.  She would give up."

"But," I added, my voice wavering very slightly, "it's not my choice.  She is still perfectly rational and can decide for herself.  She was trained as a nurse.  She knows what is happening to her."

My sister Nina and I broke the news to Mom.  We had to tell her that the potentially life-saving stent had not been successful.  She thought it had been, and had been looking at her leg for signs of improvement.  We had to tell her the options left to her.

Her face instantly told us her decision.  She did not hesitate.  She didn't even blink, looking at her leg as if it were a foreign object, considering it objectively.

"I don't want an amputation, and I don't want an operation," she said firmly but very, very quietly.  She raised her eyes to look at us.  "I am ready to go.  I want nature to take its course.  No heroics."

Nina and I wept.

Mom was dry-eyed, as stoic in the face of death as she always had been in the face of pain.

So now Mom lies in the "skilled care" wing of Quarryville Retirement Community.  She is one of the fortunate ones, cared for by people who love her, people who have chosen the hard and often thankless tasks of helping the elderly make the transition from life to death. 

I know Mom is OK with her decision.  I know she is loved.  She is at peace. 

But I cannot help thinking about others who soon will be in her situation.  I am thinking of those who may soon have their decisions made for them by a faceless and uncaring bureaucrat, not with the help of caring and loving children and medical staff.

There is so much Mom doesn't know.

She is unaware that though the House of Representatives is considering its repeal, presently included in the poisonous and monstrous Patient Protection and Affordable Care Act is the equivalent of the much-vilified "death panels" Sarah Palin had the temerity to suggest would be part of rationed health care. 

The fact of the matter is that the Affordable Care Act has established an Independent Payment Advisory Board (IPAB), which many justifiably see as Medicare's rationing board.

Mom doesn't know about the dangers of IPAB, but others do.

Others like David Catron, author of "IPAB is an Acronym for 'Death Panel," who warned us some months ago the IPAB is a death panel specifically designed to "cut funding for some health care services seniors now take for granted.  And those cuts will kill people."  Catron also warned that fifteen "experts" appointed by the president will impose price controls that stint on "Granny's physical health" in order to preserve the country's fiscal health.

It doesn't have to be this way, Catron continued: "The tragic irony here is that costs can be controlled without pulling the plug on Granny.  There are market-based alternatives to government rationing...It is, in reality, possible to utilize the market to control costs."

However, he concluded: "Unfortunately, choice is not a popular concept with the President and his health care apparatchiks at the Centers for Medicare and Medicaid Services (CMS).  For them, 'cost control' means government imposed rationing of care to the elderly." 

Grace-Marie Turner concurs, stating in a recent article in Forbes magazine entitled "President Obama's Dangerous New Medical Board" that "[t]he power of the IPAB is unprecedented because there is to be no judicial, administrative, or realistically, congressional review over its decisions."

In other words, the IPAB is totalitarian in nature.  It has authority to deny seniors like Mom any choice other than those the board determines.

Further, as Turner notes, it hopes to reduce spending by "payment reductions primarily in the Part D prescription drug program, Medicare Advantage, and skilled nursing facility services.  Since the board is forced to reduce overall Medicare spending by focusing only on these relatively smaller segments of Medicare spending, the cuts would have to be very deep to achieve overall per capita spending reductions.  Access to care inevitably will be impacted."

Mom, who is in skilled nursing care, is blissfully unaware of what may happen to her slightly less elderly friends.  Many of her friends are unaware, too.

I wonder how many of Mom's friends soon will be denied the choices and care my mother has been and is being given.  How many know that a panel of fifteen people could determine their fate?  How many realize they could be told just to "take a pill," as our president has suggested?  How many could be given just one option -- comfort care only? 

How many will be told they have just one choice -- to die?

Mom has made her choice and is fading fast.  She is anxious to leave this life behind her and to move on to Eternity.  She is one of the fortunate ones.

Of course, none of the Supreme Court justices know who Mom is.

But as they consider argumentations which include the issues of fundamental liberties, imposition of choice by the federal government, and the possible destruction of the delicate structure of federalism, let's hope and pray they do not lose sight of the most precious liberty of all -- the right to choose to live.

God forbid they lose sight of Mom.

Fay Voshell is a frequent contributor to American Thinker.  She can be reached at

If you experience technical problems, please write to