"Death Panels"?

The medical community is already moving toward sensible end-of-life care

I've had more experience with the modern health-care industry than I care to lately; I suppose you could say I've had some experience with a "death panel" as well.

It isn't one thing that gets you these days. The longer you live the more complicated your life, your health, and your maladies. My father's weak heart was treatable, but couldn't stand up to diabetes and Parkinson's disease. My mother's bad heart couldn't withstand a cancer operation and chemotherapy. I lost them both in the last three years.

At some point in their treatment, after a series of hospital stays, it became apparent that extraordinary measures were futile. We talked to the covey of doctors being paid by good private insurance and Medicare. The general practitioner, the heart specialist, the surgeons. In each case the conclusion was the same. They sent them home to die.

My father died at home surrounded by his wife of 60 years, his children, grandchildren, brother and sisters, and a host of nieces and nephews, not to mention church members and neighbors. He got daily checks by hospice nurses, the closest things to angels on this earth. Sympathetic, but firm in extinguishing false hope and pretense. Extremely competent in pain management. They kept our focus on celebrating my father's life and easing his passing.

This year we went through the same thing with my mother.

In both cases it was a stark contrast with the experience we had in past years with family members. Respirators, feeding tubes, drug-induced comas, the unreality of a hospital room as the final remembrance of loved ones. We had a horrible experience losing our parents, even more so for my sister who provided the bulk of the care, but considering the circumstances the medical system made it as good an outcome as was possible.

But in the room with family members and doctors, there were no insurance bureaucrats and certainly no federal bureaucrats. We could have insisted on extreme measures. We could have asked them to operate on our frail mother, taking the chance of her dying on the table or shortly thereafter hooked to machines and in excruciating pain. We reached the decision on what to do based on what was best for our mother. And our father. I imagine it is a situation many boomers find themselves in these days as our parents move through their 80s.

I am extrapolating from my personal experience but it seems to me doctors and health-care providers are already moving to solve the problem of hugely costly and ineffective "life-saving" measures for the terminally ill. The growth of home health care and hospice services allow the elderly to die with dignity, surrounded by loved ones, drifting out of life without being plugged full of tubes and surrounded by the sterile environs of a hospital room.

What's been lost in all the hoopla about national health-care reform is that Medicare already pays for end-of-life counseling. It's all voluntary. You have to ask for it.

What many of us are concerned about when it comes to more federal intervention in health care is that some day when the family and the doctors are making decisions about end-of-life treatment for a loved one it will not be up to them. Someone in Washington will have formulated some rules about who gets what care when. This may make economic sense, but in the real world in which families and doctors have to make decisions we don't need third parties in the room.

And we certainly don't need the heavy hand of government trying to tip the scales in the direction of denying care. We had no doubt the advice we got was in the best interest of our parents. What happens when the hospitals and the doctors are being told by the government which procedures will be paid and which are forbidden? Will we have the same confidence that the advice we get is in the best interest of our loved ones?