[John K. Matyi] I sent this letter to John E. Bircher as well as to the top commanders of the Military Order of the Purple Heart, A Congressionally Chartered Veteran Service Organization.John E. Bircher III, The National Director of Public Relations for the Military Order of the Purple Heart [MOPH] wrote on September 9, 2009 at 12:59pm on FaceBook: As his name was listed as John Bircher, National Director of Public Relations we can safely assume this is an Official MOPH statement.Here is what he wrote: [http://www.facebook.com/topic.php?uid=7007820613&topic=15527]  

“Recently, some folks have been distorting the purpose of a Veterans Affairs planning tool called "Your Life, Your Choices." The booklet is designed to help Veterans deal with excruciating questions about what kind of health care they would like to receive [or refuse?] if they are unable to make decisions for themselves, a topic that Secretary Shinseki takes very seriously as we continue to create a 21st Century Department of Veterans' Affairs that provides the care and benefits our nation's veterans have earned. The document was developed under a federally funded research grant over a decade ago and in 2007, the Veterans Health Administration convened an outside panel of experts to review the tool and assess its merits [at which time President Bush ordered the VA to discontinue its use]. Overwhelmingly, the panel of experts, which included a diverse group from the faith based and medical communities, praised ‘Your Life, Your Choices’ and endorsed its use in the Veterans Health Administration[incorrect at best]. Your Life, Your Choices’ is not an Advance Directive or Living Will, it is an educational resource. The National Advance Directive that the VA utilizes today is the same document that was authorized by the Bush Administration in 2006.”—John Bircher

I am very disappointed by the post that John Bircher recently made regarding the Planning Tool: Your Life - Your Choices on an official MOPH site on FaceBook. He either did not do any research on this VA “Planning Tool,” or he is wearing a liberal bias on his sleeve. I certainly hope it is the former rather than the later. As a Clinical Social Worker, I retired from the VA in 2004 [Positions held: Coordinator Vet Center, Mental Hygiene social worker/psychotherapist, Coordinator MHC, Coordinator MHICM program, inpatient Social Worker, all under psychiatry]. I am also a Life Time member of the MOPH and a 100% service connected veteran from the Vietnam War, so please do not simply discount and ignore my concerns. I will discuss just one area of this VA so-called “Planning Tool” and you can then decide if you still believe the Obama Administration talking points that he has provided on a MOPH FaceBook page is appropriate to post as the MOPH position.

For questions like this you [as well as others you can see in the .pdf file on page 21] are asked to give: "...one answer to express how you would feel if this factor by itself described you." The list of ‘answers’ is under the heading Life like this would be... The controversy surrounding this document surrounds one of the available choices available as an option, "Not Worth Living." . The use of this booklet was shortly used during President Bush’s second term, but when it was pointed out to him, it was immediately stopped. Early this year [2009] it was started again under the Obama administration along with a memo mandating it’s use by health professionals.

Let me give you a possible scenario of the use of this booklet. [See picture below]A veteran has been wounded in combat and as a result of his wounds he has the following life situation, [see above list] A, B, C, D, E, plus p and Q. The veteran is 63 years old [served in Vietnam], lives with his wife, also has Chronic Severe PTSD, and the average wait for appointments at both the VA Primary Care and the Psychiatry programs is at least 3 months or longer. After an appointment he is handed this booklet and told to use it in Planning for future medical Decisions. 

[Bold Questions] Have we just sent a physically and emotionally injured veteran home asking him to decide if his/her life is 'worth living'? Are we offering [suggesting] to them the option of ending their life may be appropriate? Is this VA [state}] sponsored euthanasia? Is this the type of care we want to offer our veterans? You can imagine the thought process you are asking our young and older veterans to utilize when they go home after we have given them published information that in a moment of weakness they may decide that maybe the best thing for my family would be for me to commit suicide [or refuse any future treatment]. 

I worked in VA Psychiatry [Clinical Social Worker] for 20 years [1984 – 2004]. I would never send anyone home with this booklet, even if I had gone over every line word by word before they left. Especially when our VA physicians are now given an average of 15 minutes to see a patient, that includes writing their notes into the computer. As a clinical provider at the VA I regularly saw veterans who would at the very least fall into categories "A" though "E" [see above] on a daily basis. I find it indefensible that the very organization that we expect to be the advocate for our men and woman who have sacrificed life and limb for our country would simply give a Progressive politically correct ‘Talking Point’ answer without careful consideration and research. 

I ask you [MOPH] to consider your official advice carefully. Cutting-and- Pasting off the VA website on issues that remain controversial at best, should be avoided at all cost. You represent wounded veterans, not the VA! The Secretary of Veterans Affairs in a recent interview claimed that this booklet was not in use until revisions are made. She also claimed it had been taken off the website. As of this morning the website, Your Life, Your choices was still there. If they are not using it why does it still remain available? [http://www.ethics.va.gov/YLYC/YLYC_First_edition_20001001.pdf] .

I originally downloaded this .pdf file the day of that Fox News Interview [With Chris Wallace) and at that time the following had been added to the file: 

Your Life, Your Choices Planning for Future Medical DecisionsNote –"The following is a 1997 publication that was produced under VA IIR Grant No. 94-050, “Development of an Advance Care Planning Workbook,” 4/01/95 – 3/31/97. The document is currently undergoing revision for release in VA. The revised version will be available soon."As of today [9/29/2009] the following had been changed in the publication [still on the Internet] to read: "The following is a 1997 publication that was produced under VA IIR Grant No. 94-050, “Development of an Advance Care Planning Workbook,” 4/01/95 – 3/31/97.It is posted here for information purposes. It is the policy of the Obama Administration to make available to the public scientific and technological information that is developed and used by the Federal Government. www.whitehouse.gov/the_press_office/Memorandum-for-the-Headsof-Executive-Departments-and-Agencies-3-9-09/ [This document was removed from the White House Website]

Your Life, Your Choices was officially retired from use in VA in 2007, and an expert panel was convened to review and comment on an online module version of this document that was under development at that time.The Your Life, Your Choices online module is currently being revised based on suggestions from the expert panel members and from chaplains representing eight different faith groups. The revised online module is scheduled to be released on the My HealtheVet Web site in the spring of 2010.Please note that portions of this document have been interpreted by some to be negative in tone and insufficiently balanced. The revision process is addressing these concerns. Also note that some of the links contained in the document are no longer active."

For more information, see vaww1.va.gov/health/ (VA intranet) or www1.va.gov/health/ Remember, the Secretary [VA] had claimed that it has been taken off the VA.Gov website, well that never happened and the Chris Wallace interview was weeks ago.All they have done is edit it slightly. As of today, the publication is still there and the issues I have presented are still in that document on page 21 [Which has not changed]. I want to make this very clear. The issues I am bringing to light should have nothing to do with politics. Our soldiers, sailors, and marines answer the call of duty regardless of the party in office. 

If MOPH has decided to become politically correct I will have to consider cancelling my life time membership and make this information available on my blog tp protect other veterans. I am giving you as much time as you feel you need to properly research and address this issue. But I hope to hear from you soon. The life of your members may be at stake. One last note, as a combat veteran who was severely wounded in June of 1967 [I was wounded by an AK-47 at short range on June 27, 1967 in Vietnam] I believe that this gives me the experiences and the authority to feel that this document could initiate depression and feelings of hopelessness that could possibly lead to suicide or unnecessary refusal of important life saving treatment . 

Can the MOPH take the chance that adding their approval of this document on the Internet could put even one veteran over the edge? 

[Editor] I sent this letter to the MOPH officers almost two weeks ago. so far no response. I informed them at that time if I did not receive some kind of defense for their publicly stated stand I would publish this information. I have edited the original letter to remove some of my personal information. As a retired clinical Social Worker, my greatest fear for this VA "Planning Tool" is that if even one wounded veteran would read this pamphlet given to him by a trusted VA provider and believe that his family would be better off without having him or her pulling them down, the result could be deadly. 

Please talk to your veteran family members or friends and let them know they are needed every day, regardless of their ability to provide an income or their ability to socialize. If you are a veteran, or their family member, I invite you to forward this to the Military Order of Purple Heart, as well as other veterans. Tell them you want to know if they are an advocate for the veteran, or the government. 

Website for the MOPH: www.purpleheart.org/Membership/default.aspx