The End of Life Debacle

At the risk of throwing a figurative match into a giant batch of kindling, I would like to weigh in on the subject of “end of life issues” that has prompted an angry response by citizens at town hall meetings in which they confront their elected representatives.

The issue is deeply embedded in the human psyche touching on the most basic philosophical and religious tenets that are fundamental to our concept of mortality. We know from the very moment when intelligence dawns on the human brain that we are going to die.

So what is all the mystery about? Of course people are angry. It is the paramount issue of human life. We are well aware of the inevitability of death. We are well aware too that the highest expenditures of government health care occur in the last year or so of life. Couple this fact with the necessity of saving money on our health care programs and what you get is the logical progression that leads inevitably to the of economics of dying. It is a costly business.

This is the ultimate decision for all of us. If we are useless, unproductive, terminal, hopeless, how are we to be ushered into the great beyond? Are we to be cast out like human garbage or given the dignity of survival for a time? If we are comatose and brain dead are we still people? Who then will make the decision about the speed of our demise now that we have developed the technology of life extension? Doctors can advise, but the choice is up to the living, the progeny, the loved ones, who have a compassionate stake in the speed of the outcome.

It is a deeply personal issue, so painful, so fraught with guilt and contradiction, so scary that it tempts denial. It is a decision that pits the concept of murder against that of love, compassion and the sacredness of the life, however diminished.
Many of us have spared our loving survivors the decision by coming up with written directions on how and when to stop artificial life support. In some countries governments have sanctioned assisted suicides arguing that the human being has a right to make his own decision regarding the termination of his or her own life.

Considering the technological advances in medical technology and the fact that we are living longer, there is a certain logic in end of life counseling. We are all living longer and in a very short time there will be a giant glut of people crowding the corridors to oblivion. The costs will be astronomical especially when the baby boomers hit the end of their life cycle. The bean counters will be tempted to follow the logic of swifter end of life disposal, an utterly ghoulish thought.

What scares people is not necessarily the logic of such counseling, but the very idea that such counseling could be sponsored and paid for by THE GOVERNMENT. People instinctively know that once this issue becomes part of a government program, no matter how benign at first, it reeks of danger. If there is an issue that the government should not intrude itself, this is it. Yes, it is alleged that all language about exit counseling has been stricken from the thousand page draft circulating everywhere as a kind of stalking horse for a permanent bill.

In my opinion, the mostly clueless legislative bureaucracy on Capitol Hill shot themselves in the foot when they inserted this language in the health care plan. How obtuse are our so-called Congressional leaders? Don’t they have any insight and awareness into the deeply felt fears of their constituents?

This is not a partisan issue. It strikes deep into the heart of our psyche. Will there come a time when the powers that be decide who shall live and who shall die based on their productivity and their cost to the community?

Maybe to dub it a “Death Panel” is a stretch at this point, but that, too, has a certain logic if one projects it over time. However depressing, the issue must be confronted, hopefully not by the government. Not everyone will have the good fortune to die a swift and painless death. Some will linger in pain, under sedation, still clinging willfully to life with the help of technology. Few of us will be free to choose our method of expiration.

That is the issue and the dilemma that frightens us and provokes our anger. What it tells us is that most of us do not want the impersonal government and its army of indifferent bureaucrats to be a party to this profound decision.

What seems benign at first could one day morph into a directive, a legal requirement that might force us into some action that inhibits our having any choice on this matter. Worse, we might be told some day that government directives requiring certain actions to terminate life are for the common good.

It is futile to be accusatory and point to deliberate conspiracies and false rumors. Fear and hysteria are inevitable when this subject is raised, especially in a proposed bill before Congress.

Losing control over our destiny when we are most vulnerable is a frightening prospect. Intoning the biblical suggestion, this is one issue that we must keep out of Caesar’s hands.