Death Panels

Summary:

Instead of addressing real tough issues, let's throw a fake. Death panels are a low blow fake, even for a moose hunter. But get real. Granny isn't getting unplugged, but she should be responsible to address these issues while she can, but most don't. Here's a reality check - checklist on the non-existent death panels.

√ Rumors that bureaucrats will pull the plug on sick and elderly. It's just static to avoid dealing with real issues. But are you dealing with the real issues?

√ Only 29% of people have signed living wills!! Folks are kicking up a ruckus about non-existent death panels when they haven't taken the most basic step to address what they can control about their end of life decisions and treatment. Be responsible. Sign appropriate documents: a living will to make your wishes known; a health proxy authorizing someone as your agent to make those decisions.

√ Few people take the time to understand what end of life decisions are really about. Jane Brody in her recent book Guide to the Great Beyond (a must read) notes that there no significant survival benefit for pursuing aggressive medical options over hospice! Hospice can provide a more dignified and peaceful death, chance to address religious and spiritual issues and save a fortune in cost. One of the studies she cites found that those receiving aggressive end of life intervention survived 33 days while those receiving hospice instead survived 31 days. While any such studies are subject to wide interpretation and variation, and so much depends on the facts of the specific patient, there are some really important lessons and questions. Many religions view it as inappropriate to "pull the plug" on someone, even if in a vegetative state. If your wishes whether for religious or philosophical reasons are not to be removed from a ventilator or to have mechanical feeding cease, even if you are in a persistent vegetative state, make these wishes clearly known. They should be respected, health care reform or not. However, broad generalizations are dangerously inappropriate. If you face days of invasive medical procedures and what might be at most statistically insignificant longer life, or you can spend statistically about the same time in hospice, with the warmth of family, the guidance of your spiritual adviser, etc., even for someone with a strict fundamental faith what is preferable? Too often the decision is reduced to black and white inaccuracies, just like the death panel hyperbole. Consultations with appropriate advisers (medical, religious or other) is the only way to make informed decisions. Everyone should endeavor to address known issues and likely scenarios in advance. If the unforeseen occurs, that is why you should have a signed health proxy or medical directive appointing someone to undertake this analysis on your behalf.

√  Of the meager 29% who have living wills too often the family disregards a parent's end of life wishes and don't disclose the documents. Instead, out of guilt they often opt for aggressive end of life treatments the parent didn't want, or they pursue what they believe to be religiously correct regardless of your religious beliefs. Think what you want, but the incidences of family members intentionally not disclosing living wills seems tragically significant.

√ Almost no families hold the recommended meeting with their advisers to discuss what often are widely divergent religious issues of their children (or other loved ones) and the impact on end of life decision making. While unpleasant and difficult, it will always prove easier to deal with then the explosions that too often occur when a parent or other family member is near death.