WaPo Highlights End Of Life Care Problem

The Washington Post had an excellent article Friday on end of life care in America. It focused mostly on how doctors or nurses, particularly in an ICU, are faced with agonizing situations due to a patient's wishes not being clear when it comes to what they want at the end of the their life.

The important take away on this story for me is that we really need to address our end of life directives with families and friends so they understand what is wanted at the end of life. (For the record, I have no interest in living on machine in a vegetative or non-recoverable state. My wife and I have talked about that). I get that the conversation may not be easy to have, and it probably won't be fun, but it is necessary. With all of the medical advancements that we have, it would be easy to prolong somebody's life far beyond what they may have wanted. And the suffering that can introduce, for both the patient and the family, is tragic.

As our country ages, these discussions need to happen and they need to happen with doctors as well as family members. It's sad that Medicare is only "considering" adding reimbursement starting in 2016 for this type of counselling. It could have, and should have, been added much earlier but it was too easy for people to start screaming about "death panels" and the idea was dropped. Having a conversation about what you want the end of your life to look like is not a "death panel". It's a smart, thoughtful decision to help guide your family through what is a miserable and stressful time.

I also believe that the other side of this is that there needs to be more laws in place like Oregon's "Death With Dignity" law. This allows patients who have a terminal disease to end their life on their terms, with help from the medical community, to avoid the suffering of a debilitating disease.

Facing your own mortality is something that is probably not a real settling thought but it is a reality that you cannot escape. It is better to make sure that the people whom you trust to take care of you understand what you want. If you want people to take every measure possible from tried and true to experimental to keep you going, that's perfectly OK. You just have to make sure people know that. If you wind up in a coma and after 2 weeks doctors say there is no hope of ever recovering and, if in that case, you want the plug pulled, that's perfectly OK, too. Just make sure people understand.

We aren't going to live forever and you never know when the end will come. Do yourself and your family a favor and make sure people understand how you want your life to look when the time comes.

Information about Advanced Directives and other end of life care can be found at the National Institute of Health's website.