End-of-Life Care in the United States
There have been a huge number of lies thrown about recently regarding end-of-life care and the health system in the United States. I’d like to take some time to address this issue.
Most people would like to spend their final days and hours in their homes, perhaps lying in bed, surrounded by their family and friends and the sounds of the voices of their loved ones one.
That, however, is not the reality for many people. What often happens instead is the dying individual is in a hospital, hooked up to machines, and the sounds of beeping and whirring medical machines–or even the sounds of arguing over what the patient truly would have wanted to happen at the end of their live.
But who knew what they really wanted? If the subject was never brought up, this burden is placed upon loved ones who must guess what it is their mother or grandfather or sister of lover wanted. Did they want to be allowed to drift off quietly? Or did they wish instead to “not go gentle into that good night,” utilizing all that medical science has available?
If a discussion is not had, then loved ones must make the agonizing decisions regarding what they hope and believe the dying would have wanted.
And it can be worse than that. One sibling may believe a parent would want to be allowed to die peacefully, while another may just as strongly believe that all measures should be taken to keep the parent alive.
These are discussions that can tear a family asunder and create irreconcilable rifts and animosity.
When your doctor wants to discuss end-of-life care with you, it is these issues she wants to discuss. She does not want to force you to end your life against your will, she instead wants you to make your wishes known to her and to your family, so that these decisions can be made in accordance with your will, instead of in a panic of grief.
Take a moment and think. How do you envision the end of your life? What do you want? What do you want to have happen to your body? Would you like your organs to be donated? Would you prefer to be cremated or buried? Do your loved ones have any idea what your wishes would be at the end of your life? Ask them. You may be surprised at their answers–as well as at their own wishes.
When your doctor asks about end-of-life planning, it is to facilitate such discussions. It is to keep your loved ones from having to make such decisions for you, through their grief, with only vague ideas from long ago discussions to guide them.
It is to be compensated for such discussions that end-of-life discussions were entered into the Health Reform Bill. Currently, many insurers do not pay doctors for such discussions. Add to that the fact that many doctors never learned how to discuss such matters with their patients, and you have a situation where doctors do not initiate these discussions with their patients, and where decisions are left unmade until it is too late for the patient to have any input.
Please discuss your wishes with your family and physician, and please, when you hear someone ignorantly spout nonsense about death panels, gently educate them as to what end-of-life care truly is, and how much of a difference it can make in the lives of the dying and their families.
Our deaths are inevitable. How our last days and hours are spent is not.
