Commentology: Obama and End-of-Life Care

THCB reader Molly Holmes wrote us to say:

As a member of a hospital geriatric emergency team, I’m on the front lines of a major health care issue that need immediate attention. The costs of keeping a person barely alive during their last few weeks of life easily run into the millions. The procedures undertaken at such times are painful and poorly thought out, and do not at all increase the quality of one’s life. The unfortunate senior who falls into the end-of-life emergency medical cycle can expect his or her final days to be miserable and lonely, with family relegated to the sidelines, while medical people rush around administering “care.” Such a person is robbed of dignity, and robbed of the right to die with loved ones nearby.

The reason why medical teams are pressured to perform endless procedures on our most ill seniors is because the legal and ethical issues at stake are in limbo. That’s because the questions raised are not just for individuals to answer, but for society as well. They are questions for a nation.

Our President injected himself into this conversation recently, by pointing out folly of the total hip replacement endured by his grandmother weeks before she died. His comment was pertinent, and any health care worker who was paying attention should have been pleased. We’ve all been there, poking and prodding someone who is well into their ninth decade of life, thinking to ourselves, “What do we think we’re doing?”

But rather than appreciating the chance to work out a helpful policy that would be good for everyone, the media pushes the Republican “death panel” distortions. All news organs mention Palin’s and Huckabee’s fabrications again and again, letting their lies go unchallenged, muddying the air with nonsense, as if the President and the Democrats honestly want to enter the business of cutting people’s lives short. That’s ridiculous and everyone knows it. So why does the Right Wing Scream Machine get a free media pass to spread their fabrications? Because Sarah Palin’s lies are flashy and dramatic, that’s why. Honestly, before someone is pulled into spreading that woman’s nonsense, they should take a walk around an Intensive Care Unit and see what’s at stake.

Molly Holmes

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9 replies »

  1. Molly,
    Thank you for sharing your perspective on end of life care dilemmas, which so many of us encounter. Engage With Grace (www.engagewithgrace.org/) actively encourages individuals to consider their own end of life care wishes based on five key questions. The idea is that people not only commit to being able to answer the five questions for themselves, and for their loved ones, but that they then spread the word – to family, to their book group, to their colleagues – to anyone and everyone, really. It’s worth checking out.

  2. Either Obama is right and he can truly cut $500 billion of waste, fraud and abuse out of the Medicare budget or Medicare dependent seniors must die when $500 billion is cut from muscle and bone because there really wasn’t that much fat.

  3. Well said,PICUDoc. This is at the heart of all this debate–who pays?? It is all too easy to prescribe all sorts of approaches when it is OPM. One way to address this of course is to “allow” people to buy varying levels of insurance. If you want every last ounce medicine has to offer, pay the premium. If you re willing to take your chances or keep yourself in shape etc. then you can pay less for less coverage.
    And the original post is only half insightful. yes it is ridiculous to prolong life by days or hours at great expense–esp other people’s expense. The “death panel” red herring took off bec there will be rationing. I just read there are discussions of how to ration ventilators if the flu gets bad.
    And about BO’s grandma, why the hell didn’t he tell her to not have the hip replacement?? Was it forced on her and the family by a mean insurance company? He full of it.

  4. Like the author I am also on the front lines of end of life issues. It pains me to see some technology dependent patients suffer away and we can’t say no since that’s just the American way. I think rationing is a good idea.
    Personally, if you want keep your child/parent (barely) alive and vegetated on a ventilator and feeding tube, that’s fine with me as long as you pay for it. The BILLIONS of PUBLIC health care dollars from our taxes would be better spent on other health care initiatives that provide more bang for the buck.

  5. What makes you think that’s even a possibility?
    Becuase it is done in other countries who systems the left claims they want to copy.
    Because the government publishs poorly written books given to our military members discussing end of life ina way some perceive as pushing it.
    Molly you should learn the difference between a lie and difference of opinion. The fears expressed by Palin and millions of others are legit. If you where at all familiar with healthcare delivery in this country as it relates to government control you would know just because a bill isn’t labeled death panels doesn’t mean it doesn’t lead to them.
    As an example of your lies please point to the federal law that says if you drop Medicare the Government will take away your Social Security Benefits. Hint their is no law but by stretching the intent of other benign laws they accomplished the goal.
    Little less preaching little more education you would understand the concern about death panels.

  6. It is a very difficult decision as it invloves emotional values but I have seen sometimes due to legal bindings million are spent to keep a person on life support for years. Personally I feel I would never like to have this kind of life.I would rather prefer a smooth death but who should take this decision is important and critical.

  7. I think it would be helpful if we, as a society, developed ways to significantly increase the percentage of the population, especially among those 65 and over, who execute living wills or advance medical directives and that we ensure that the information is readily available to doctors and hospitals when needed. More importantly, however, I think the medical profession will have to eventually modify how it defines and applies good, sound medical practice. Communicating with patients and their families regarding the available medical options as well as the quality of life implications of each also has lots of room for improvement, in my opinion. It seems that many of the heroic interventions that do little more than prolong the dying process by a few days or weeks amount to doing (often expensive) things TO the patient but nothing FOR the patient. The management of end of life care is one area where we can learn a lot from our friends in other advanced countries, and it has nothing to do with rationing or death panels. It’s mostly about common sense.

  8. I also don’t want the government or anyone else making the decisions…
    Of course not. What makes you think that’s even a possibility?

  9. Molly,
    I agree that no person should be dragged through medical procedures to prolong their life if that is not what they want, however; I also don’t want the government or anyone else making the decisions about whether or not it’s time to stop care on me or someone I love. That is a personal, or at LEAST a family decision. I am no expert on this, but if I’m not mistaken, you can talk with your loved ones about signing a DNR (“Do Not Resuscitate” for those who may not know what that stands for) if they are in a condition that would make it undesireable to have a medical team go to heroic efforts to keep them alive. Wouldn’t that accomplish the same thing?