This is not a political post. I am an independent voter and have been so most of my life. Well one time I did register as a Republican but I have gone before the church and repented of that one. I can see both sides of the current screaming match about health care. I almost called it a debate and wish it were one, but all I can see is wild screaming of set points over and over again. The one thing I take issue with is someone calling a session with a doctor to talk about end of life decisions a death panel; that somehow the government was going to put in panels of doctors and who knows who else to decide who lives or dies. Scared the pants off of some folks of course and maybe that was the goal, but it did great harm to those who see the need for finding comfortable ways to make end of life decisions.

We not only need to make these decisions, we need ways to be sure they are followed. I cannot tell how many families I have sat with in hospitals while they mourn the fact that their aging loved one’s life was being prolonged far beyond hope or reason but were helpless and powerless to stop the procedures. There was no living will and no power of attorney for health care so the decision was out of their hands, and the physicians are pledged by oath to extend life, not shorten it. 

This extended care is a major part of the health care cost. We spend a very high percentage of the cost of Medicare on the last few weeks of life, a lot of the time when it is more than evident there can be no positive outcome from the care. This is not some conspiracy among doctors to increase their incomes, it is just how the system is designed or how it is not designed. We have no way of actually looking at these issues and now when someone tries to make it possible for a family to sit down with a doctor to talk through these decisions and it be paid for through Medicare or insurance, somebody ups and calls it death panels and we end up having visions of someone meeting to see if grandma is important enough to live. 

This is as close to mad as you will ever read at this place, but I have good reason. I stood by helplessly while by-pass surgery was performed on my mother-in-law after the heart doctor had told us there was nothing there to operate on. Her heart was almost dead and she was far too old for such invasive surgery. She lived through the surgery and had maybe one month when she was well enough to get out of bed and sit in a chair before she died.

I came home from a trip to find that my father was scheduled to have his testicles removed the next morning. When I asked the doctor why he said it would relieve the pain he was in, but he was not in pain. The surgery would not extend his life in any way, it was just what the system called for with his disease. I had power of attorney for health care and the operation did not happen. Had I not been in town? That is why the idea of paying physicians to sit with families and talk through all of the options and desires ahead of need is such a good idea. 

As medicine advances and becomes more and more able to sustain life beyond the time when the body no longer can sustain itself, it becomes more and more important that we give very serious consideration to what we want to happen to us when that time comes. I had to decide to stop nourishing my father. That decision was possible, and I was able to face it, because of talks with him and the family and because his primary physician was willing to sit with us and tell us our options. If that was a death panel then I hope everyone gets one. 

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