End Of Life Care Research Paper

First Last
Ms. Cobb
ENGL 1213/0272
28 September 2011 “Death Panels”: How Should the Medical Profession Handle End of Life Care?
End of life counseling sessions where doctors advise patients how to conduct their own deaths have stirred up a firestorm of controversy in the press. These are sessions where a patient, who is terminally ill, talks with their doctor about their last wishes before they get to a state where they can no longer communicate, e.g. comatose. Supporters of these sessions hope that the dying and their doctors will have honest and open talks about death, coming to terms with this reality and being better prepared for it when it comes, putting the quality of life as defined by the patient over their quantity of life, which naturally would be critically short. Critics of the idea use the term “death panel” to imply that no consensus between doctor and patient would be reached and government programs would decide when to “pull the plug on grandma” and coldly decide when a patient should die. One of the biggest questions within this issue is how realistically we could approach an equal-sided doctor to patient counseling session. The balance is between
letting doctors, with their education and experience, decide when a patient should be taken off of life support; or whether this highly personal decision should be left only up to the patients and the family. It’s between making medical procedure mandatory even though the patient is destined to die soon or letting the family dictate how much their doctors should do for their loved one. The term “death panel” was first coined by Sarah Palin in an accusatory Facebook post in August of 2009 during the government health care debates (Bank). She lashed out at Obama’s reform measures stating: “The America I know and love is not one in which my parents or my baby with down syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide…whether they are worthy of healthcare or not. Such a system is downright evil” (Palin). This false projection of end of life counseling sessions quickly exploded into a media uproar, and new healthcare legislation that would provide these end of life counseling sessions for Medicare beneficiaries was removed from the bill (Gawande 47). Critics coined new phrases such as “Pulling the Plug on Grandma” and “Rationing of [government] Services.” These phrases paint physicians wishing to honor their patients’ last wishes as heartless, soulless, money-grabbing machines. And although these views may be extreme, there are real fears present about the idea of having a talk with a doctor about how a person’s death should be approached. For an overstressed, worried relative of a patient, seeing a Do Not Rescutiate (DNR) order above their loved one’s bed can cause panic, if not downright hysteria. The inability to accept that there may be nothing else a physician can do may create a difficult obstacle in doctor-patient relations. There is a consensus among end of life counseling critics that the patients, those paying for healthcare, should dictate when doctors should stop performing procedures. The question naturally follows: Should patients and their families be allowed to control their own healthcare, or should doctors say when enough is enough? The case for end of life counseling sessions hopes to put this decision back into the patient’s hands. By informing the patient of the probable outcomes of continuing treatment and the possible consequences, the patient is able to come to terms with their own fatality and handle themselves with more grace in their last days of life. A patient could say good-bye to his loved ones, write a living will, and tie up his life’s last affairs. He would not feel that he was burdening his friends and relatives with sky-high medical bills; in fact, patients who went through end of life counseling sessions paid an average of $1,876 for medical expenses compared with $2,197 of those who did not (Goler). The patient’s family would not have to make difficult decisions regarding his/her care, the patient would be making these decisions himself/herself. By enabling this patient to see death as an inevitable and natural occurrence, we return a sense of respect to the process of death in our society. We allow patients to say that they would rather die awake and mentally aware, surrounded by the ones they care about rather than in a comatose-state hooked to an infinite array of tubes.
If a patient chooses to die naturally, it will also be much easier on their family. They can see their parent, spouse, or grandparent pain-free and at peace in his last minutes of life. They will know that the patient died without any regrets, and instead of worrying if they had made the right choice for him/her, they know that this choice was made by him/her. They will leave with much less grief and suffering. About caregivers of the recently deceased, an article published in The New Yorker stated that the caregivers of terminally ill cancer patients were “three times as likely to suffer major depression” if the terminally ill patient had been given electrical defibrillation, chest compressions, or had been put on a ventilator (Gawande 40). End of life counseling would have provided peace of mind and grace for these patients, and their families would have recovered much more easily after their passing.
The final party that end of life counseling sessions would benefit is that of the doctors and the healthcare profession. The truth is, to portray doctors as heartless, soulless, money grabbing machines is an insult. Doctors do genuinely care about the welfare of each patient and do not want to cause needless suffering for the terminally ill or their family. Physicians, unlike families, are not overridden with fear and stress when a terminal crisis arises and instead they can rely on their years of experience and cool-headedness to judge the situation. Doctors need to be the link to sanity that their patients crave in times of chaos. Aside from these emotional benefits, the fiscal benefits of end of life counseling sessions are astounding: “Twenty-five per cent of all Medicare spending is for the five per cent of patients who are in their final year of life, and most of that money goes for care in their last couple of months which is of little apparent benefit” (Gawande 38). Eliminating these costs would be instrumental in balancing the government’s struggling healthcare budget. By allowing the doctor to have these very frank and personal talks with their patients, doctors become more relatable, more human; instead of the purveyors of immortality they become compassionate equals hoping to advise their patients into making the best decision possible. When patients and doctors see eye to eye and they are able to make consensual decisions that are better for all involved, we instill a greater future trust in our medical system and its ability to provide for our welfare. Through end of life counseling, we can renew the human relationship between physicians and patients and make the process of losing a loved one much easier to work through. When presented with the facts, end of life counseling sessions are very fair and patient-oriented.
These doctor-to-patient sessions have nothing to do with the government run “death panels” described by Sarah Palin consisting of impersonal juries of accountants who only see the bottom line. Instead, end of life counseling puts the control back in patients’ hands, allowing them to dictate when and how they would like to die. These counseling sessions seek to nurture better relationships between doctors and their patients and plant seeds of change in a culture where death is no longer respected or valued. They diminish grief and suffering in the ill and their loved ones. End of life counseling sessions are a real solution to the issue of dying with dignity in a modern day healthcare
facility.
Works Cited
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Gawande, Atul. “Letting Go.” The New Yorker 86.22 (2010): 36-49. The New Yorker. Web.
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Goler, Wendell and Stephen Clark. “End of Life” Counseling Intensifies Health Care Debate.
FoxNews.com. Fox News Network, 08 August 2009. 08 September 2011.
Grier, Peter. “ ‘Death Panel’ controversy remains very much alive.” Christian Science Monitor
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