How can we change American attitudes toward "last months" of life?
This question is prompted partly by a recent story on 60 Minutes that I didn’t pay a great deal of attention to, but I’m aware of the issue. It’s also prompted – more – by my close association with my elderly uncle.
The national issue is that Medicare (from the little that I gleaned from the 60 Minutes story) pays a huge percentage of its total outlay caring for the elderly in the final month or two of their lives. The national question, distilled, is “How much is a month or two of bedridden, pain-filled, insentient or barely sentient life worth?” Consider that at this point in some unfortunate people’s lives, they are permanently supported by non-portable machines: ventilators, respirators, dialysis machines, heart monitors and machines that I can’t even name. And the patients are not improving or expected to improve. Further, unless they have DNR orders (Do Not Resuscitate) or other specific instructions to staff regarding prohibition of “heroic measures” to save their lives (and those instructions are followed, which isn’t a given), they may be “rescued” at the point of an otherwise peaceful death and kept alive indefinitely – for what purpose? Even worse from a budgetary point of view (and yes, life does come down to economics sometimes), people on Medicare are not prohibited from any service that might “enhance” their lives in a “recommended medical” way because of cost. So people in this condition can receive joint replacements, heart and other organ transplants and other procedures irrespective of cost (or expected long-term prognosis) even in the near-certain knowledge that the person will die within a month or two, and nearly 100% within a year.
On a personal note, some of you know that last winter, and again this winter, I have moved in with my elderly uncle (barely ambulatory, occasionally senile, incontinent and not enjoying his life at this point) while his daughter and son-in-law leave the state for their own much-needed time off. Last year he was recovering from a lung infection and mesothelioma that had him in the hospital for a couple of months in the summer, and has taken him nearly a year to “recover” from. He has frequently, in his entirely lucid moments, wondered aloud, “Why can’t I just die?”
I second that.
I’m not about to murder him, and he has not specifically requested assistance with suicide, so I haven’t made (and I’m not asking for!) any plans with that. But if people saw me keeping a dog alive in this condition they’d rightly call me a monster.
Why can’t we let people die in peace any more? Why can’t we recognize that sometimes the “temporary problem” that Voltaire noted (“suicide is a permanent solution to a temporary problem”) is that “it’s time for life to end”, and allow or even encourage human euthanasia? I’m all for palliative and hospice care, but our American attitude towards death is somehow obscene.
Hey, it’s in Social, so feel free to include jokes. At this point I’m recognizing what a joke life can be (a dirty joke sometimes), and I’m ready for a laugh.