Death panels? How about compassion panels?

Whoever called it "end-of-life" counseling made a terrible mistake, not only from a marketing perspective, but from an ethical/spiritual one. By ceding values-laden language to their opposition, and failing to approach this issue from a values-driven perspective, they opened themselves, and all those who support this much-needed aspect of health care reform, to the death panel crowd and their charge that such counseling is about nothing more than cost-cutting. Nothing could be further from the truth.

While we may not all agree about the circumstances under which medical care should move from therapeutic to palliative, or from palliative to passive, it is always a dignity and compassion issue and we would have been better served had it been called dignity and compassion counseling, for that reason.

Such counseling, which would be offered, not imposed, under the proposed reform legislation would be a godsend for many people who find themselves in need of such expertise and unable to access it when they need it most. And let's be clear about the fact that such conversations are happening anyway as more and more people have to make actual decisions about the end of their own lives an the end of those they love.

Death doesn't just "happen" as much as it used to, especially for those who have access to the latest medical technologies and interventions. And so, much as we may hate it, choices must be made.

That's not a rationing issue, that's a taking charge of your own life issue. Until relatively recently, such choices were few and far between. Now however, we often have the technological capacity which demands that we make such choices, and simply knowing that we can do something doesn't necessary mean we should do it.

We need to distinguish the difference between having the knowledge/capacity to do something and possessing the wisdom to determine whether or not we should. Compassion counseling, end-of-life counseling --call it what you will, simply invites us to be better informed about that kind of complex question.

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If people find that threatening, it is either because they have never faced those painful questions personally, or can not rest until all people are forced to make the same decision they would under similar circumstances.
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Having been called upon to make such a decision, I quite agree. At present, we are in a no man's land. Doctors often won't tell us the true prospects of a patient because they are not certain of what we "wish" to hear. I kept getting confusing answers until I went and researched the issue in depth, acquiring a medical vocabulary specific enough to speak in terms of organs, etc.

At that point, and only at that point, was I given the truth, the facts. Still, it was not a mere matter of logic. There is no hope, so, therefore, don't bang on her chest to resuscitate her. I had to watch her; we all did, try to get a sense of what she was experiencing, etc., read as much as I could, speak to friends wiser than I, etc.

I don't know what kind of panels are needed. I do think that if we are dealing with kin who do not have living wills, we need to know the facts of their conditions, above all. Then, we need to be in a better position to advocate for their care, not merely, regarding whether or not to let them go. Finally, yes, "compassion" counseling might not be a bad idea for those who need it.

However, the issue is not whether we find someone else's suffering painful. The issue is that human being, that human being, alone.

Posted by: Farnaz1Mansouri1 | November 6, 2009 10:39 AM
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Brad Hirschfield

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Death panels? How about compassion panels?

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