Proposed health-care reform legislation includes a provision that allows Medicare to pay for "end-of-life" counseling for seniors and their families who request it. The provision—which Sarah Palin erroneously described as "death panels" for seniors—nearly derailed President Obama's health-care initiative. Some Republicans still argue that the provision would ration health care for the elderly. Does end-of-life care prolong life or does it prolong suffering? Should it be a part of health-care reform?
How do we define life? Is it merely brain waves and motor activity? Or is life defined by living in a broader sense? And who decides when life is over? An individual, family members, care providers—or some government entity?
The argument against the end-of-life provision is that—as Sarah Palin and other Republicans assert—the government and healthcare providers would determine an arbitrary age when life is considered over. They claim that the government is eliminating choice, when in fact the provision would expand choice by allowing the elderly to make informed decisions about how they want their lives to end.
My 92-year-old mother has outlived all her siblings and peers; she can’t see or hear very well, but her heart is strong and she’s healthy in every way. Yet she delights in her children and grandchildren and knows her life still matters. She recently wrote a living will refusing life support if needed. When the time comes, we’ll do everything we can to eliminate pain or suffering, and we will honor her life by honoring her choice.
Life is a series of choices. Most of us have the freedom to make decisions that shape the quality of our lives. As we reach old age, though, often the power to choose is abdicated to someone else. The ability to choose for ourselves ultimately determines our engagement in life, and when we can no longer choose, we’ve lost something precious. If choice is what determines full participation in life, the new end-of-life counseling for seniors is empowering and life-giving.
In 2008, nearly 40 percent of deaths in the U.S. were under hospice or palliative care. In its current form, palliative care does prolong life—perhaps beyond what individuals themselves want. But the new provision does not prolong life nor does it prolong suffering; instead it empowers the elderly to decide for themselves—while they are still able—how they want their lives to be lived out.
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I like the idea of "expanding choice" I would have liked for you to enlarge on that. Its a good point, though, that we need to put the power back into the hands of the people whose lives we're deciding on.
ReplyDeleteDefining life as more than just brain waves and activity is a good point. I have experienced, however, that even a comatose patient can have purpose. It's a tough call, and one that must be made personally, as you said. Empowerment.
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