Make Lahaina Bypass signs more visible

It took us almost two weeks to notice the bypass. Why? The signage is very poor.

Please put up the big green signage at least 500 feet or more before the intersection so we can see it. With the traffic volume so high, you can’t see the current little white cross only three feet off the ground.

It will be so nice when there is an extension added. It’s a beautiful new road. We are Canadians staying at Napili.

LESLIE REECE

——————

Make bypass signs bigger

After spending the money to build the Lahaina Bypass, why didn’t you spend the last dime on a decent size sign?

Maybe put up informational signs at the Keawe Street and Hokiokio Street intersections.

I like David Rockett’s suggestion to call it the scenic route.

ANGIE GIBSON

——————

Yellow ribbons and endless war

“By God,” Bush said in triumph, “we’ve kicked the Vietnam syndrome once and for all.”

George H.W. Bush made this statement a quarter of a century ago while celebrating the terrific poll numbers his quick-win war on Iraq was generating. Remember the yellow ribbons? I think Bush had a point. “Vietnam syndrome” – the public aversion to war – still has a shadow presence in America, but it no longer matters.

America’s official policy is endless bombing and endless war. No matter how much suffering it causes – more than a million dead in Iraq, Afghanistan and Pakistan – and no matter how poorly it serves any rational objectives, our official response to geopolitical trouble of every sort is to try to bomb it into compliance with our alleged interests. The cancerous “success” of this policy may be the dominant historical event of the last three decades. Endless war is impervious to debate; it’s impervious to democracy.

When President Bush launched his bombers on Jan. 17, 1991, it was in the full glare of the public eye, recorded for all to see. There was no veil of secrecy and no secret furnaces, burned documents or counterfeited flight reports. After a four-month-long on-air debate among politicians and pundits, “smart bombs” lit up the sky above Baghdad and Kuwait City as the TV cameras rolled.

There were yellow ribbons around every light pole as Bush proclaimed that “Vietnam syndrome” was dead. All it took was a permanent shift of responsibility away from the public at large – via elimination of the draft – combined with an ultra-sophisticated public relations effort that successfully turned our former ally, Saddam Hussein, into The Face of Evil.

The slaughter of 100,000 Iraqis during the month-and-a-half-long Desert Storm was, apparently, a small price to pay for the good we had accomplished, and seemed not to mar the post-invasion celebrations.

A decade later, another Bush in office, the Towers went down. George W. proclaimed that America would take on Evil itself. And even though his successor, Barack Obama, is swept into office on a global hope for peace, war remains the default setting. Fourteen years in, war does, indeed, look endless.

Obama recently announced, for instance, that he won’t be the one to pull U.S. troops out of Afghanistan. War is now impervious to democracy, despite the incredible harm – the millions killed directly and indirectly because of the war on terror, 60 million refugees worldwide, numerous countries in chaos – it continues to cause.

Maybe, as scattered individuals, we long for peace, but for now, the interests of war are safely fortified from our longing. As we stand against these interests anyway, let’s continue to declare our belief that war is never the path to peace.

ROBERT KOEHLER, PeaceVoice

——————

How to ensure people get the end-of-life healthcare they want

My mom paid a painful price for not completing an advance directive about her preferences for end-of-life medical care. She was an intelligent and organized woman who had everything in her and my dad’s life planned out and written down. She even drafted her own obituary. Ironically, she never discussed her end-of-life care goals with my father or her physician son (me), preferring to talk about “more pleasant subjects.”

As a result, after she developed colon cancer at age 86, my dad and I had to figure out how to treat her post-surgical medical complications of heart and renal failure. She died in hospice care after prolonged, unbearable and unnecessary suffering. It broke both my dad’s heart and mine.

Unfortunately, my mother’s story is all too common. A key reason for this problem is only about one out of six Americans (17 percent) say they have had discussions about their end-of-life healthcare goals, preferences and values with a doctor or other healthcare provider, according to a recent Kaiser Health Tracking Poll.

Evidence-based research overwhelmingly shows the need for more and higher quality doctor-patient conversations about the patient’s healthcare goals, preferences and values. The report, “Dying in America” by the Institute of Medicine, noted that most people nearing the end of life are not physically, mentally or cognitively able to make their own decisions about care. The majority of these patients will receive acute hospital care from physicians who do not know them. As a result, advance care planning is essential to ensure that patients receive care reflecting their values, goals and preferences.

One important step that should facilitate advance care planning is the Centers for Medicare & Medicaid Services’ recent decision to reimburse doctors, starting Jan. 1, 2016, for communicating with patients about their preferences and values about end-of-life care. As a next step, we urge CMS to stop reimbursing healthcare professionals for providing unwanted medical treatment that directly violates a patient’s documented end-of-life care goals.

In addition, we encourage Congress to take additional steps to ensure that Americans get the end-of-life treatment they want.

Absent of healthcare reforms, poor understanding of treatment options and/or lack of acknowledgement of the extent of the illness may lead to inadequate planning, dissatisfaction with the process, unnecessary medical treatment and loss of quality of life.

DR. DAVID R. GRUBE, Compassion & Choices