Conversations over death

As the Republican-lead House prepares to undo “Obama Care” I was thinking of one aspect of that care.

Death Panels—the pejorative term given the forward-looking provision in the federal health care law by the right-wing-nut pundocracy. It’s fitting that the leading sick elements of an unhealthy culture like ours would be offended by a provision to fund “end of life” conversations between terminal patients (no matter their age, but most would be with elderly patients) and their doctors about their impending end. Unfortunately, our medical system doesn’t provide the time needed between doctor and patient to have these discussions. Unfortunately, I have had such conversations. I am not a doctor, so please allow me to explain.

I lost two brothers and a sister to cancer. My older brother Jim died at 40, younger brother Terrence died at 41, and older sister Kathleen died at 55. (BTW, I am 54.) When my sister was lying in a hospice bed with, at most, only a few weeks to live, the doctors said we had a choice to make. So far to that point all the treatments to stop the disease had not worked. The medical professionals were at the point of going into what they termed “experimental” procedures as a last-ditched effort. They wanted to know the next day if they should continue trying or give up, from a medical stand point. They said the experiments would put her in a cloud and she would hardly be conscious but may give her some more time, if they worked. The question was one of quality of life. How did my sister wish to go out, under a cloud of experiments or live her last days with the pain kept under control but allowing for some human contact with her loved ones as she left this world? I spend the night with her discussing this. She chose to be a participant in her last days.

Dying a slow death from a disease like cancer in a way cheats death. Any one of us can die at any moment. Hit by a bus, gone. A slow death offers a chance to shape your end, to clear up unfinished business, to tell those you love how much they meant to you. Once you accept your end you can create the space to go in peace, to accept letting go. Many terminal patients never get to this point, sometimes it’s by choice but often the medical folks throw everything they got at the problem because that seems to fit the oath they take. Science doesn’t like to admit failure. Sadly, both my brothers didn’t really get to that point of having an open, honest conversation so they left unfinished business that the rest of us who loved them had to deal with after they were gone.

In the end, life is a death sentence. We are all terminal. The so-called Death Councils of the right are a deliberate distortion stemming from their own fears. The focus of such a conversation is about quality of life at the end, not forcing people to feel guilty of all the medical expense they are costing, etc. A culture that denies death lives in fear of it. A culture that lives in fear of death can’t really live. Like the line in the song I wrote for my sister Kathleen, “There’s only meaning to this life when you learn how to die.”

Check out today’s story on Democracy Now



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