Politics and an exploration of dying
One of the things that has been thrown against the Obama administration regarding health care reform has been euthanasia. The right throws up a lot-- health care changes will bankrupt us but also that Obama will kill all the old and sick. Can something bankrupt the federal treasury when it would actually be killing off or denying care to anybody who was sick?
As I have said before, the right wing doesn't use logic for its arguments. It is emotion driven and this is just another example.
Some do worry about euthanasia. We saw that as the right fought against Oregon's Death with Dignity law which is not an involuntary euthanasia bill but rather one that deals with end of life decisions. It empowers a dying person (6 months or less to live certified by doctors) by giving them the option of a prescription for pills (two psychologists have to attest they are in their right mind and understand their decision) that would end their life at a time of their choosing, not the disease's. It formalized what has happened for a long time, and it drove the right as nuts as the Terri Schiavo case.
The right wing doesn't like people to have control over their own lives. They claim to be the party of freedom while they would limit entertainment, education, sex, and how you die. A year ago they might have thought a living will was acceptable but today, if you would be talking to a doctor about it at all, it's not. Death panels was the accusation thrown out by Sarah Palin which of course was picked up by right and left media. Don't kid yourself. Left wing media loves these stories and milks them every bit as much as right wing media.
Since this all reminds me of our personal experience with end-of-life decision making with my mother-in-law, I thought I'd share it. The photo above was taken in 1998. It is of me, her granddaughter, her first great grandchild, and her son. She was 94. About a year later, she fell in her living room (she lived in an assisted living apartment) shattering her hip. Farm Boss raced to the hospital to find out what the situation was to be. The doctors recommended a hip replacement.
That took some real thinking on her part and ours. At that point she had about 5% kidney function and at almost 95, what would be the odds of her being able to withstand such major surgery? We knew how hard it would be on her body. Still she also had a spunky spirit and without that surgery would be doomed to stay in her bed the rest of her life.
The decision, from doctors and family, never for one minute revolved around the cost but instead quality of life. The decision was not impacted by the Oregon Death with Dignity law because she was not someone with a terminal illness. Although she had failing kidneys (Type II Diabetic), there was no end of life prognosis. The idea of her taking pills to end it more quickly never arose with anybody and I don't see that it would with the health care reforms that are being suggested as very few states offer the option anyway. It's been rarely used in Oregon although more have gotten the prescriptions to know they could if they wanted but died comforted by being in control.
My mother-in-law came through her surgery but suffered a lot. She never really recovered and although she had physical therapy, she died a little over three months later in a care facility that offered more services than her assisted living complex had been able to provide.
Was her surgery the right choice? It was expensive but who could know for sure that she might not have gotten up and made it back to being as mobile as she had been? I think it was the right thing to do but still know it was a hard choice which was made by her doctors, her, and her son as it should have been.
My mother-in-law is a prime example of the dire possibilities that the Republicans are trying to use to frighten the elderly. She is also a good example of someone who had a living will.
Anytime she had any surgical procedure she was required to once again sign a statement of what she wanted done should she be unable to respond in anyway other than as a vegetable. She did not want to live on tubes. This choice in her case, and my bet is in most all cases, is not about economics; and if any of you have faced it with a beloved family member, you know it's not. It's about quality of life. There is more chance it would be about economics with the current insurance (profit oriented) companies in control than with the government (Medicare).
Currently the Republican hysteria has led to taking from the bill the right for any Medicare patient to go in for an appointment (their choice not a requirement) to discuss end of life options in their current medical situation.
Thank you Congressional representatives and especial thanks to Sarah Palin for hypocrisy and once again taking from the ordinary person choice regarding their own lives.
The irony of the 'family based,' Republican party is they don't trust the family to make these decisions. They want rules in place that dictate the choices and we see that time and again. The irony of Democratic, so-called progressive party is their lack of courage to do anything they claim they want. Maybe they never wanted any of it to begin.
The right wing should be ashamed of itself but it isn't. Emotion driven as it is, shame is not one of those emotions. What it has done, in an attempt to destroy Obama's effectiveness, is what they did with Clinton. They go after things that have no real meaning (birth certificates, death panels). Yes, Democrats went after Bush but on policy regarding actual issues like fighting wars, torturing, spying on its own citizens, eliminating the right to trial when accused.
The right isn't attacking Obama on his ideas which is what they should be doing. It's on his race (if you don't believe me look at what even legislators are saying, the signs at these right wing hate rallies, the birther movement, the tea partiers ). The right also goes at it by throwing out a myriad of charges (in the case of Clinton it was the death of Vince Foster, mysterious deaths around the Clintons, sex scandals) and seeing what sticks. When the right finds a charge that works, they all jump on it and that's what happened with living wills.
I have to revise my will and make sure that I add the living will part to it. We do this with a computer program that we purchased. You have it notarized when you sign it at a bank, and it's very legal. I know I would not want to live as a vegetable and would not want extraordinary measures taken to keep me alive if something should happen. Temporarily on a feeding tube is one thing but permanently is not. Extending dying is not living.
Although I have told all my family members of my desires, I know from the experience with my mother-in-law that you have to sign such things again anytime you enter a hospital once you are a certain age-- or you used to before the party of death began raising such a stink. And stink is the only appropriate word for what I have been hearing. It's sickening and, as usual, doesn't help any real discussion on health care reform.
There should be a real discussion on how to fix what is a damaged program and not just based on those without insurance but the growing cost of having medical care period. If you start with protecting the profits of insurance companies, you aren't ever going to have meaningful help. If you don't know health care's true cost today, it's because you already have an employer or government paying most of yours. That's not free, you know!
[For those of you interested in astrology, check out: Rainy Day Extra for Lynda Hill's newsletter regarding August 20th]
6 comments:
My experience with end of life of my mother was different. The quality of life was impacted negatively by not having medical providers in geriatric care who would take her. She was diagnosed with Alzheimers' type dementia by the administrater doctor of a nursing home, the only place that would take her without a medical physician. There was no other doctor who would take her when I moved her from Southern California to our home in Oregon. Her new doctor, the nursing home administrator, would not look at her neurologists' records from Scripps' Hospital. According to the Scripps neurologist she had normal aging memory problems. After about a year at the Oregon nursing home, my mother said she had cancer and the new doctor would not honor or investigate the notions of a confussed person.
A year and a half later an x-ray showed what appeared to be a lymphoma. This was a nightmare three and half years seeing my mother suffer and not being able to find health care within the area. Traveling in a car was extreemly painful for her or I would have taken her to a larger city.
From my experience the best that can happen in our national health care crisis is to keep the health care issues alive and keep hacking at the law making and eventually we will have a health care industry that will be vital to our country.
I believe the focus of our attention in health care is on insurance companies and that is only a small sliver of the problem with health care. I am looking for a more complete definition of the problem. But maybe that is not the way law making works and we need to just chip away at the problem with what can be accomplished in one legislation.
The question for me is this: why do you and Parapluie make so much sense while all the nutcases on TV sound completely insane? Why aren't reasonable people doing the talking? Why does the wacky message get the headlines?
I so appreciate your reasonable discussion about this. Thank you.
Even a living will is not a for sure answer. It is very important that those who will be making decisions after the patient has been put onto life support know their wishes. And at that point is it critical to have good medical information- is the current condition something he/she can recover from or is it permanent? Then very hard decisions have to be made by those family members who are charged with making life or death decisions. Believe me, it isn't easy.
Parapluie brings up another problem with our current system. Too many docs will no longer take new Medicare patients. This is at least partially because there are not enough medical docs going into general or internal medicine but instead into a specialty where they will likely make a lot more money. I don't know what the answer to this problem may be but I do know that very few med school graduates have paid their own tuition & costs. Maybe we need some requirements regarding how many can go into those specialties and how many will go into internal medicine.
Go easily into that good night to paraphrase a poet.
Rain, Paul's family had to make one of the most difficult decisions because no one really knows whether an operation is a good idea for the very elderly. In my case, I didn't have any other serious illnesses and the prognosis of a good outcome meant there was no decision to be made, but had I suffered from other debilitating diseases, I do know if I would have had a hip replacement. At the time I didn't know that most elderly patients who have hip replacements die within six months. (Fortunately for me that I was uninformed).
That brings up a whole new issue. If I had not had a hip replacement would the cost of my care in a nursing home exceeded the cost of the surgery? When money is part of the equation it really becomes a sticky wicket.
I have had a living will for years backed up with a medical power of attorney. I have also talked to my children and they are all in agreement that I will have no heroic measures if I am pronounced terminal. It is a great relief to have the knowledge that the decision has been made.
I did not have to sign another statement as to my wishes when I entered the hospital. I did talk to my surgeon (who I had never seen before) and made sure he agreed with my living will. I think this issue might be one that the hospital required to cover themselves in the event of a lawsuit.
I am all for the death with Dignity Law that we have in effect in Oregon and Washington. Not many here have taken advantage of it, but some have, and the family is so grateful to have had that choice. We are so much kinder to our dying pets than we are to our dying parents! what a pity that priorities are so skewed!
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