On End of Life Counseling

Since I blogged two days ago about my opposition to certain phraseology used by Rev. Jim Wallis, I want to say something about the quote to which he is responding.

I find the “death boards” complaint about health care easily the least well-founded and most damaging of the issues. There is good reason to discuss health care and how we can provide it for the uninsured. I think there is good reason to debate the public option. In fact, there are many things that are questionable.

But a provision providing for payment for end of life counseling is a good idea, no matter who is footing the final bill. Setting aside the issue of who should pay, end of life counseling can be extremely important and can greatly improve quality of life.

I have sensed that many people have a great deal of difficulty facing these issues. I used to be one of them. I didn’t want to disuss it. I didn’t want to think about it. I think many fear to deal with these issues, but I can’t be sure what someone else is thinking. I was afraid.

Being married to a nurse who was a hospice nurse and then director of education for a local hospice organization for 12 years, and then living through the death of a child has changed my attitude.

The worst possible thing at end of life is to face the choices you must make without having planned ahead of time. In order to plan ahead of time, you need good information. I remember sitting in an oncologist’s office one day with our son forcing him to be explicit about the numbers and the value of various treatment programs. You have to know that the information is there and then get it.

I have now made a living will, and I encourage everyone, young or old, to do so. It will give you peace of mind to think about the issues and make your decision. I’m not trying to tell you what decision to make; I’m simply suggesting you think about the issues, make the decisions, and put your will in writing.

Might a doctor discuss things in a counseling session that I might not regard as moral? Certainly. Should that session be government censored? I strongly believe it should not be. It is interesting to me that there are people who very strongly oppose anything that might get between doctor and patient and their choice in general (though insurance companies do this all the time), yet they don’t want government insurance to provide for this kind of counseling, if there is a government insurance option.

My own decision is that in very few cases would I support heroic measures to extend my life. That doesn’t mean that I would not choose surgery or chemotherapy based on the best medical device. But if prolonging my life involves hooking me up to a machine permanently, I’m not interested.

It’s odd that some people seem to think that this is an attempt to choose the time of my death. I think the reverse, that technological efforts to keep a body that would otherwise have given up may well be the case of trying to force my continued life after God has chosen for me to go.

I hope to leave this world not kicking and screaming, but rather rejoicing.