We have no choice in how we come into this world, but many of us will have an opportunity to exercise some control over how we leave it.
We can and should give our families and caregivers some instructions about what kind of life-sustaining medical treatment we find acceptable. That should be our choice — an informed choice based on whatever counseling and input we seek from family, faith advisers and medical professionals.
Somehow, end-of-life care has become a political football in the United States. During contentious discussions about the federal health care overhaul, the mere act of offering people information about end-of-life choices has been demonized into a plot to implement “death panels” that make decisions about how and when people should die. The issue arose again last week when the Obama administration approved a new policy, which went into effect Saturday, allowing Medicare to pay doctors for informing patients about options for end-of-life care.
Again, doctors are offering “information.” They are not making decisions. Doctors are giving people the information they need to make decisions about their own care rather than having those decisions made by someone else when they are no longer capable of making their wishes known.
This is not a “death panel” or the first step toward legalized euthanasia. It is an opportunity for individuals to guide the care they receive at the end of their lives. It is an opportunity for a patient to tell doctors and family members that he or she doesn’t want to be resuscitated and kept alive on a ventilator after all hope of recovery is past. If they don’t want to leave specific directions about what treatment they do and don’t want to receive, they can simply delegate those decisions to trusted friends or family members, with whom they have shared their wishes. There is no death panel, no doctor or government entity turning thumbs up or thumbs down on a patient.
People facing a terminal illness are allowed to make choices about their care or lack of care. Although it may be hard for family members to accept, patients are allowed to weigh the effects of aggressive medical treatment against the potential benefits of that treatment. Advanced medical directives simply extend a patient’s right to make those decisions to a time when they will be unable physically to express them.
To equate end-of-life counseling with death panels is a huge disservice to patients and their families. Being able to discuss and express end-of-life treatment choices actually puts control for those decisions firmly back with individuals who leave clear instructions for family members and medical professionals. It makes sure people receive the treatment they wanted, not the treatment someone else chooses.
Medicare recipients should be encouraged to talk about end-of-life care decisions with their families and their physicians, and it’s not unreasonable to reimburse doctors for the time they spend providing information to their patients concerning those choices. Discussions about end-of-life care are just as important as discussions about any other care decisions that patients must make. We shouldn’t be afraid to have that conversation.