Discussion leader: Jim Phillips
Just because we can extend life, should we? The U.S. is expected to spend $2.8 trillion on health care in 2012. Medicare alone will cost taxpayers $590 billion, with over 25% going toward patients in their last year of life. If health care is a scarce resource, limited by its availability and our ability to pay for it, should government step in to ration care, deciding whose life is worth saving? In other words, how much is an extra month of life worth?
For The Motion
The U.S. spends more on health care than any other industrial nation—in 2012 we are expected to spend $2.8 trillion. We cannot afford our health care system and expensive end-of-life care costs are a major contributor to this problem.
Rationing means getting better value for the trillions we spend every year.
Rationing already happens. Medicare decides what it will reimburse, private insurance decides what they will cover, and individuals go without care and medicine every day when they can’t afford it.
We must ration based on cost-effectiveness, not on an individual’s ability to pay.
If we spent less on those who, with or without treatment, have only a few months left to live, we would be better able to help those who may have decades.
Against The Motion
The government should not have the power to determine who lives, who dies, and who gets treatment based on calculations of quality and quantity of life.
Health care costs can be reined in without rationing care.
Targeting “end-of-life” care specifically would result in very little cost savings.
Rationing care will lead us down a moral slippery slope. How many years of life is enough? Who is productive and worthy, and who is not?
https://www.intelligencesquaredus.org/debates/ration-end-life-care
In 1994, Oregon voters passed the Death with Dignity Act, which legalized physician-assisted suicide for the terminally ill. Since then, it has become legal in 4 more states, including New Mexico, where the state court ruling that it is constitutional is under appeal. Is it, in the words of the American Medical Association’s code of ethics, “fundamentally incompatible with the physician’s role as healer”? Will these laws lead to a slippery slope, where the vulnerable are pressured to choose death and human life is devalued? Or do we need to recognize everyone’s basic right to autonomy, the right to end pain and suffering, and the right to choose to die with dignity?
For The Motion
The right to die as one chooses—and to decide when life is no longer worth living—is integral to human freedom, liberty, and personal autonomy. Neither the government, nor religious institutions, should impose their own conceptions of morality upon individuals who are not harming others.
As an option in end-of-life care, aid in dying would allow terminally ill, mentally competent individuals to retain dignity and bodily integrity in the face of insurmountable pain and suffering.
In places where assisted suicide is legal—namely, Oregon and the Netherlands—there is no evidence that the law is being abused, that vulnerable populations are being targeted, or that patients are being coerced by doctors and/or their families to choose death.
If physician-assisted suicide remains illegal, lesser and more dangerous alternatives—shooting oneself, enlisting doctors or family to break the law, DIY suicide—will spread in its place.
Against The Motion
If assisted suicide is legalized, we will be led down a slippery slope towards pervasive medical killing, endangering vulnerable populations—disabled, elderly, minority, or poor—whose lives are seen as a burden on society.
If pain is treated effectively, there is no need to treat the patient as if the patient were the “problem to be eliminated.”
Starting with the Hippocratic Oath, medical professional codes prohibit killing, holding the intrinsic value of human life and dignity above all other ethical principles. Assisted suicide erodes the doctor-patient relationship and has grave potential for misuse and abuse.
Many physicians do not want to have God-like power over others, and they should not be pressured, against their own convictions, to assist in a patient’s suicide.
https://www.intelligencesquaredus.org/debates/legalize-assisted-suicide
As people approach the end of their lives, they and their families commonly face tasks and decisions that include a broad array of choices ranging from simple to extremely complex. They may be practical, psychosocial, spiritual, legal, existential, or medical in nature.
http://www.apa.org/topics/death/end-of-life.aspx
End-Of-Life Policy Solutions: A Cautionary Note
https://www.healthaffairs.org/do/10.1377/hblog20170710.060992/full/
Ethical Issues Surrounding End-of-Life Care: A Narrative Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934577/
How to Curb the High Cost of Caregiving
https://www.barrons.com/articles/how-to-curb-the-high-cost-of-caregiving-1521253021
HOW TO ENROLL IN VETERANS HEALTH INSURANCE (TRICARE)
http://www.dummies.com/personal-finance/veterans-benefits/how-to-enroll-in-veterans-health-insurance-tricare/
How to grow old in your own home
https://www.fidelity.com/insights/retirement/aging-in-place
Paying for Care
https://www.nia.nih.gov/health/paying-care
Problems and Solutions in End-of-Life Healthcare
http://www.healthleadersmedia.com/leadership/problems-and-solutions-end-life-healthcare#
https://www.wsj.com/articles/how-to-talk-with-your-dying-loved-one-1523891127
The Darien Historical Society’s current exhibit is called “Long May She Wave” — the chronological evolution of our Flag. It features a number of genuine historic flags, plus many more replica flags from the pre-Revolutionary War era to modern times.
“Beautiful, The Carole King Musical,” tells the inspiring true story of King’s remarkable rise to stardom, from being part of a hit songwriting team with her husband Gerry Goffin to becoming one of the most successful solo acts in popular music history. Along the way, she made more than beautiful music — she wrote the soundtrack to a generation.
William Frederick McClelland, Jr., a Darien resident since 1958, died on January 7, 2018, at home. He was 92.
Rocco A. Evola, a resident of Darien, CT, passed away on Sunday, January 7, 2018 at home in Darien. Born on June 29, 1919 in Flushing, NY, he was the son of the late Rocco Gaetano and Maria Smania Evola. He was 98.
Wednesday, February 28, 2018
Michelle Beltrano and Karen Goersch will lead a practical discussion on common pitfalls and current opportunities in estate and financial planning. The objective is to ensure such plans accomplish the intended goals. Michelle will talk about myths and surprises about estate planning documents. She also will explain how to start the conversation of estate planning with loved ones. Finally, she will cover the cost of settling an estate in Connecticut and what to expect from the probate process. Michelle lives in New Canaan with her family and is principal and founder of Beltrano Law, a boutique firm located in Greenwich. Her practice areas include estate planning, elder law, special needs, probate matters and estate administration. Michelle represents individuals and families who are dealing with complex matters, including Medicaid eligibility and applications, long-term care planning, will contests and trust administration. As an attorney and nurse, Michelle has unique insight into her clients’ situations and provides individualized, concierge services.
Karen Goersch will provide several tips to help ensure that clients effectively implement their estate plans and meet financial goals, such as the titling of assets, beneficiary review and gifting strategies. She also will discuss selecting which assets to deplete first, considering future estate and income tax implications. She will show how to use insurance as a tax-planning strategy to potentially eliminate the IRS as one of the biggest beneficiaries. She is a financial advisor with Ameriprise Financial in its Westport office and holds several professional designations, including CPA. She works with a team of professionals to develop personalized financial plans and investment solutions, helping clients simplify complex issues, often with a focus on tax minimization and efficiency. Karen moved to Rowayton a year ago after living in Darien with her husband and twins for more than 20 years.
Wednesday, February 14, 2018 
On January 25, 1917, HMS Laurentic struck two German mines off the coast of Ireland and sank. The ship was carrying 44 tons of gold bullion to the still-neutral United States via Canada in order to finance the war effort for Britain and its allies. Britain desperately needed that sunken treasure, but any salvage had to be secret since the British government dared not alert the Germans to the presence of the gold. Lieutenant Commander Guybon Damant was the most qualified officer to head the risky mission. Wild gales battered the wreck into the shape of an accordion, turning the operation into a multiyear struggle of man versus nature. As the war raged on, Damant was called off the salvage to lead a team of covert divers to investigate and search through the contents of recently sunk U-boats for ciphers, minefield schematics, and other secrets. The information they obtained, once in the hands of British intelligence, proved critical toward Allied efforts to defeat the U-boats and win the war. But Damant had become obsessed with completing his long-deferred mission. His team struggled for five more years as it became apparent that the work could only be accomplished by muscle, grit, and persistence. Using newly discovered sources, author Joseph A. Williams provides the first full-length account of the quest for the Laurentic?s gold. More than an incredible story about undersea diving adventure, The Sunken Gold is a story of human persistence, bravery, and patriotism
dnesday, February 7, 2018 
Wednesday, January 31, 2018 
Wednesday, January 24, 2018
