Avoiding end-of-life chaos

Q: Does end-of-life care prolong life or does it prolong suffering? Should it be a part of health-care reform?

When I first heard that health-care reform might include end-of-life counseling, I thought: "Why should the health reform bill have to provide funds for that?"

But then I remembered that, far too often, people are not prepared to die. People do not want to talk about dying, and they end up leaving this earth with their affairs in horrible shape, and their families swirling in mists of confusion complicated by grief.

Death is a part of life, but too many who are alive will not face that fact.

End-of-life counseling, as I understand it, just tries ensure that everyone knows what your wishes are, should you become gravely ill. Do you want to be kept alive on machines? Do you want extraordinary means used to keep you alive?

End-of-life counseling is not some "death panel" deciding that some people should die and others live. Rather, it is making sure that when anyone dies, he or she can do it with dignity and with the family fully informed.

Just last week a young woman in my congregation died suddenly following surgery. I have seen that happen far too often. With well-off families, arrangements can be made without much ado, but in poorer families, making arrangements is a strain, and the entire situation is made worse when the family has not a clue about what the deceased would have wanted. So, it would seem that not only seniors would need this type of counseling, but younger and poorer people as well.

For an idea that is so humane at its core, it sure stirred up a lot of fear and angst. What on earth would make someone refer to end of life counseling as a "death panel?" Does that point of view belie an even greater disconnect we as people have between life and death? Are we so afraid of death that the mention of how to make that part of our lives easier - for us and for our loved ones - leads us to panic and irrationality?

End-of-life counseling should be something required of everyone. When we walk around with our heads in the sand, acting like death will not get us, there is something very wrong. With birth comes growth, with growth comes maturity and with maturity comes death. It is called the circle of life.

I hope this health-care reform bill passes soon, and I hope the end-of-life counseling is funded. Bigger than that, I hope people will take advantage of that funding should it be provided, so that their end days can be as free from confusion and angst as possible.

Death will come. We ought to be ready for it, in as many ways as we can.

By Susan K. Smith  |  November 3, 2009; 1:58 PM ET
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