Patients benefit from talks
- David Gillaspie
- Portland Tribune - Opinion
TWO VIEWS: Proposal to fund end-of-life talks prompts new debate over how to care for the dying
Oregon wins the trifecta for end-of-life debate: Oregon Senate Bill 451 establishes the nation's first state registry of people's wishes for end-of-life care; U.S. Rep. Earl Blumenauer's H.R. 1898 allows funds for doctors discussing end-of-life choices with their patients; and the state has allowed physician-assisted suicide/death with dignity as a final option.
In spite of the ominous sound of all three, a hearse is not shuttling people to the end-of-life discussions provided by H.R. 1898. Patients will meet with their doctors - not their executioners.
At the end of the day we ask the same question for our loved ones: 'Will treatment improve quality of life in the short or long run, or at all?'
Declining treatment is a huge decision. Everyone has to agree, starting with the patient. If they aren't competent to make a decision, it falls to the family. Some are more organized than others. H.R. 1898 acts as a conversation starter.
Does it take federal legislation to ask a doctor about end-of-life issues? Why not just ask? I did. My father-in-law was in the hospital after a long illness. He didn't look good. I asked his doctor how long he had to live.
The doctor said 'maybe two days to live, probably less.' He didn't ask me to make another appointment before talking about it. I brought Ken home for his final hours. Nothing went according to plan after that, but I don't blame the doctor.
At some point you get two choices: A natural death in step with the sunrise and sunset of your last days, or a frantic rush from operating room to intensive care to recovery, repeated until you finally give out.
In one scene you are a beautiful flower blossom fading at the end of the season. In the other you are wired up and plugged in with regular jolts of heart-start as needed. You'll either have familiar faces hovering over your bed, or sleep-deprived residents working their caseload notes.
Pneumonia has been called 'the old man's friend.' Everything slows down and shuts off. It's a more acceptable death than doctor-assisted suicide. Is it more acceptable than running seniors through batteries of tests and drug regimes at the end of their lives?
A conversation about end-of-life treatment is not with greedy relatives manipulating vulnerable seniors for gain - it's with their doctor. It doesn't mean the senior citizen needs more anti-depressants for wanting to talk about end-of-life choices; it's a conversation with someone who knows the particulars of the case.
It is the one conversation you want to have before you find yourself thinking, 'I wouldn't wish this treatment on my worst enemy.'
H.R. 1898 pays for end-of-life treatment appointments. Those with loved ones near life's end understand how difficult it is talking about limiting treatment and do-not-resuscitate orders. It can create added tension to already tense relationships. A doctor can review the subject, give the options and let the patient and family decide the next step.
Because you have insurance that approves every treatment available doesn't mean you are required to submit to every treatment. Listen to the doctor's opinion, and then say thanks or no thanks.
Terminally ill people can take comfort in knowing their loved ones stand beside them regardless of their choice. If the love of a family is the best medicine, let's help doctors play a more useful part.
David Gillaspie is a writer living in Tigard.