End-of-Life Choice, Palliative Care and Counseling

Good-bye Elizabeth Edwards: Thank you for Lighting the Wayby Barbara

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Still recovering from last week’s distressing Frontline revelations of how life ends for cancer patients in the intensive care units of New York, I feel enormous gratitude to Elizabeth Edwards for showing us how to meet an imminent death with grace, courage and wisdom.

What a contrast between the sense of darkness, denial and disaster embedded in those hospital patients and their families, and the vivid celebration of life and love that surrounded Edwards as she died among loved ones, in her own home. What a gift to see her carefully take her leave, imprinting memories on friends and children to inspire and guide them their whole lives.

While there was a fight to win, Mrs. Edwards fought hard. But unlike the dying patients in the Frontline piece, medical science served her needs, not the other way around. While the Frontline doctors asserted that long-shot, dangerously intense treatments are to be endured as what “drives medicine forward,” Edwards’ physicians candidly advised her further treatment would be “unproductive.”

Thus, medical science released her to her own best judgment. Elizabeth Edwards possessed the intellect, stature and courage to negotiate that release. The choice of dying in peace and comfort should not be the exclusive domain of those with money, power and negotiation skills. Hospice, the great idea almost entirely absent from the Frontline piece, should be the treatment of choice for everyone in the situation Edwards faced.

CNN noted this well. They quoted Dr. David Casarett, of the University of Pennsylvania. “People in hospice don’t want to die. They want to live, and they want to live well,” he said. “They want to use whatever time they have to live the best way they can. I don’t think it’s giving up. It’s making a careful choice. The easiest thing is to go after treatment after treatment, and say yes to whatever gets offered next,” Casarett added. “The bravest thing is asking yourself what’s important, who’s important, what’s best for you and your family and choosing hospice that way.

Elizabeth Edwards did all that in spades. She understood Dr. Casarett’s words, their wisdom and their promise of hope: “Throughout my life, both personally and professionally, I have had the opportunity to see how people have been affected by illness and loss and the role the healthcare system may have played as they dealt with change in their lives. I also know that people can find a great deal of hope even in the most challenging of life’s situations. Hospice and palliative care professionals support and care for people at a time when hope can be hard to find.”‘

When hope of conquering cancer becomes vanishingly small, another hope arises. This is the hope of dying well, dying gently and in comfort and peace with loved ones close. Elizabeth Edwards hoped for that and achieved a great success in making it happen. May her lesson help light the way and heal our broken manner of dying in America.