Read My Lips

It's Not a Death Squad

Thousands of people are protesting the health care plan being considered in Washington for all the wrong reasons. They are zeroing in on the section on end-of-life issues and promoting the idea that the provision means the government will be telling people when to die.

Sarah Palin is one of the most out-spoken, and perhaps influential, people stirring up this frenzy. In her blog and elsewhere she uses rhetoric that doesn't enlighten. It just stirs up emotion. This is from a commentary about her blog:

Palin was quick to note that the health care plan could make decisions regarding anyone at the end of their life, which might include her baby. She believes her parents and baby will have to leave it in the hands of Obama’s “death panel” to determine whether they are worthy of receiving health care. This is certainly not something anyone would want to face or see their loved ones experience.

The truth about that provision is that the government would provide funds to educate people about the importance of making end-of-life decisions and using Advance Directives and Medical Power of Attorney documents to make their wishes known. This isn't something we are comfortable talking about, but tough questions need to be asked and answered.

If you have cancer and are 80 years old and have a heart attack, do you want full resuscitation. Do you want to be on a ventilator in ICU?

If you have been in an accident and are brain dead, do you want to be kept on machines for an indefinite period of time?

If you have a terminal illness and can no longer eat, do you want tube feedings?

I worked for eight years as hospital chaplain and dealt with many situations where these questions had to be answered during times of extreme emotional distress. Family members were looking at their loved ones and feeling a desperate need to keep them alive. Because their emotions were so raw, they couldn't see past that to the pain and misery their husband, wife, mother, father, sister or brother might have been going through.

Being in ICU on a ventilator is not a pleasant experience.

And it is an extremely expensive proposition.

In our medical ethics sessions we would often discuss the sad fact that thousands of dollars were spent daily to keep a body alive when a person should have died days or weeks earlier without the pain and desperation that is so often the case in an ICU.

Which doesn't mean that every case in ICU or Oncology is hopeless. But many an ICU nurse would share their frustration with me over the fact that they had to keep sedating some poor old lady who kept trying to pull all the tubes out and that poor old lady died a week later anyway. She just had seven days of misery. And took seven days of time and attention that needed to go to a patient who had a chance for a positive outcome.

As part of my job, I had to start talking to patients about Advance Directives. It was easier to talk to them and to families when they were not in a crisis situation. It was also easier on them to have someone trained to deal with death and dying issues and with what the documents provide. Which is the point, I think, of this provision in the health care plan.

I know. I wish I had someone to help me talk to my mother about this.

So, if you want to protest the health care plan, protest because it is going to cost too much. Or protest because it is going to be administered by the government, who are so efficient with administrative matters. But don't protest the end-of-life provision.

We all need to think about how we are going to go "into that goodnight."