End-of-Life Choice, Death with Dignity, Palliative Care and Counseling

Posts TaggedBlumenauer

Health-care reform: Distortions doom end-of-life counseling

From the Seattle Times
Sunday, August 16, 2009

IN the end, sensible end-of-life counseling proposals in health-care reform had to be dropped, because too few Americans bothered to understand what was being proposed.

From a practical standpoint, consultations must be removed from the legislation to save more-pressing elements of reform. Willful distortions of optional end-of-life counseling spiraled out of control. This is not a proud moment in American politics.
Financing beneficiaries’ optional consultations about a range of end-of-life care is a good idea. Families need it. Patients benefit.

But a well-orchestrated rumor campaign ensured this element of the plan could not survive. It became too much of distraction.

The idea that the government would stage death panels cutting care to critically ill patients is an absurdity, perpetuated by conservative publications and a woman, Betsey McCaughey, whose claim to fame is trashing Former President Clinton’s health-care reform.

Sarah Palin joined the frenzy, proving how dangerous she would have been as vice president.
Ironically, the idea for such consultations supposedly came from Georgia Sen. Johnny Isakson, a Republican. Doctors, patients and families will have to wait for a saner moment in the debate to include this important care.

Sometimes, hysteria wins. What a shame for those who may not have access to information that would aid them in making excruciatingly painful decisions.


Hello! We are Mortal! Grow Up and Plan Accordingly!

The Senate Finance Committee may strike end-of-life consultation reimbursement from their version of the health care bill, so maybe the hysteria will die down. But it’s sure to rise again if the provision survives in the House version. Will Congressional leaders summon the courage to deliver an adult response or cave in to hysterical attacks?

It’s remarkable how easy it’s been to gin up a frenzy of fear and anger with scary messages that remind people death is inevitable. Most politicians say they support advance directives for end-of-life planning and encourage their use. At least they did until a few days ago. That’s when the idea took hold that it’s highly dangerous and tyrannical to encourage doctors to talk with patients about what kind of treatments they would want if they were terminally ill and unable to speak for themselves. That’s why the provision to reimburse doctors for the consultation can’t be part of health insurance reform. Apparently this would be the first step to a Nazi regime, where doctors somehow profit from euthanizing their paying patients and panels meet to decree the death of granny and disabled children.

The national dialogue leaped from modest proposal to outrageous hyperbole so fast it’s clear something profound and quite apart from advance directive consultation was at work. International professionals in end-of-life counseling joke that in America people think death is optional. It certainly seems true, to judge by the public’s tantrum after being reminded it ain’t so.

Hello America! We are all mortal! It’s our fate. Adults know this in their hearts and the wisest among us live every day conscious of life’s impermanence. A mature society would have handled this differently.

One of my favorite poets, Edna St. Vincent Millay, wrote, “Childhood is the kingdom where no one ever dies.” Apparently that’s the fantasy some of our national leaders want to promote. “Terry Schiavo will be kept alive even if it takes an Act of Congress!” “No one need ever discuss with their doctors how their life might end.” Such attitudes treat American citizens like children, too young to come to terms with their own mortality. Why should we be surprised to see town hall displays of childlike temper tantrums? Treat people like children and they will act like children.

Playing into America’s pathological denial of death is to treat mature individuals like children, and very young children at that. Researchers and clinicians tell us it’s normal for children 3 to 5 years old to deny death is final. Telling a very young child Granny is “asleep” or “on a long journey” supports the denial. Between five and nine years old children come to accept that death is final, and can think about it’s happening to others. By about age ten a child is usually ready to start thinking about her own death.

National leaders deliberately sparked fear and anger over a consultation about death and sensational media threw fuel on the fire. They would have us remain a nation of five year olds, stuck in an infantile refusal to acknowledge, grieve over, and plan for, our own deaths or the deaths of those we love. For shame. Certainly that’s no way to come into our greatness as a nation. Certainly such stunted psychological and spiritual development is not what it means to be a human, created, as many believe, in God’s image.

No, coming into the fullness of being means living a life of thoughtful judgment and conscious decisions. And that includes decisions about the end of life. Recently the New York Times carried a story of the care and intention with which the Sisters of St. Joseph manage the individual deaths of their aged nuns as the entire order gradually dies out. They are thinking about their dying and they are talking about their decisions. “We approach our living and our dying in the same way, with discernment,” Sister Mary Lou Mitchell told the reporter. “Maybe this is one of the messages we can send to society, by modeling it.”

In Adulthood — a kingdom still distant from our shores — leaders will foster dialogue and pass laws to help their constituents on that very human quest to discern and embrace both life’s sweetness and death’s certainty with a similar quiet grace.

Compassion & Choices Hosts Capitol Hill Briefing

Summer is here.  The nation’s capital and the health care reform debate are heating up!  June 19th, Compassion and Choices hosts a briefing for policy makers on a topic vital to honest discussion and careful decision making.

Ensuring Patient Wishes at the End of Life
Breaking Down the Barriers to Quality End-of-Life Care

Speakers will include:

• Jennie Chin Hansen, R.N., M.S., F.A.A.N., AARP President

• Kathryn L. Tucker, J.D., Director of Legal Affairs, Compassion & Choices

• Howard Tuch, M.D., American Academy of Hospice and Palliative Medicine

Compassion and Choices organized this briefing to discuss how Congress can advance solutions to break down the barriers to quality end-of-life care. All staff from the House of Representatives and key Senators have been invited.