JENNIFER RUBIN: David Brooks’ “Scary And Sloppy” Case For Health-Care Rationing. “Perhaps the point is to rationalize reductions in health-care dollars spent on the elderly, which by gosh is precisely what the Obama administration is trying to pull off with its Independent Advisory Patient Board. Limiting care, conscience free! After all, do all these old people really enjoy living to 90?” The “Death Panels” used to be a dishonest Republican talking point. Now they’re for your own good!

UPDATE: Reader Mike Ramberg writes: “The best argument that I can think of Against Don Clendinen’s essay and David Brooks support of same is Dr. Steven Hawking. He can’t do any of those things, yet he seems to be a rather productive member of society!”

ANOTHER UPDATE: A reader emails:

I am an RN and run a palliative care program for a home health agency in Northern California. These articles all raise very interesting and salient issues, but I’d like to make a couple of observations, from what I know:

It’s fascinating that hospice is not mentioned by Clendenin. This is consistent with what I have dealt with in my work, but that is the service that would most further his goals, short of shooting himself as he so cavalierly seems to think is an option. I have made visits with people who are dying of ALS, and they tend to not want all the interventions he is bringing up such as the vent and tubes, as they are well aware that their condition is terminal. When terminal, hospice best serves people. As an aside, I found it disheartening that the two big media champions of “health care reform,” Ted Kennedy and Elizabeth Edwards, chose to spend health care dollars on probably futile treatment at the end of their lives, rather than accept the inevitable and transfer to hospice.

Brooks’ column is annoying in that he does not seem to understand the very real issues surrounding the end of life. Cardiac disease can be managed in palliative ways, but often people panic and want to return to the ER for treatment until they no longer feel better after repeated hospitalizations. But to blame this on “Americans’ inability to deal with death” is condescending and unrealistic. These are conversations that rightly belong within the family and with medical professionals, not politicians. These conversations are immensely private and deal with one’s view of life, death, and morals that pundits cannot ascertain by reading one man’s struggle with his terminal condition.

“Condescending and unrealistic” — that could be Brooks’ epitaph, once he’s too far gone to enjoy life. I should note, though, that although hospice care gets good press, when my father-in-law was dying, the folks from the hospice were pretty awful. The funeral home people were much better, once he died. I was appalled.