End of life extravagance

July 11, 2013 | By | Reply More

In the Washington Post, Jonathan Kay writes:

Last week, I wrote a column about the problem of “unwanted care,” a term used to describe the aggressive, invasive, often debilitating heath treatments that are imposed on dying patients — frequently when they are senile or unconscious — during their last weeks or months of life. The example I provided, courtesy of Atlantic magazine author Jonathan Rauch, was of a 94-year-old man dying from internal bleeding and kidney failure in a U.S. hospital. Instead of providing palliative care, the doctors tried to get authorization to remove the man’s colon and put him on dialysis. “We are spending billions on health care that no one wants, and which often has no real effect except suffering and indignity,” I argued.

I often wonder how different it would be if we all agreed ahead of time in the abstract that insurance simply won’t cover extending the heart beats of people who are inevitably dying, either unaware or unconscious. I suspect that if standard health policy insurance money weren’t easily available, many of us would quickly decide that life was at an end, that it was a natural process, and that it is simply time for him (or her) to go.

With the aid of easy medical insurance coverage, though, many of us take the position that every heartbeat of life is sacred, even when the patient is unlikely to regain consciousness, and if that, only for a few more weeks in an extremely frail state. In big families where many members recognize the futility of extending unconscious dying life, there is often one or a few outspoken members of the family vocally urging that every last dollar must be spent to extent the number of heartbeats, guilt-tripping those members of the family who know how to accept dying as a part of life. As it is whenever something is declared to be sacred. Dying in the presence of easy insurance coverage is something to be fought at all costs, with no compromises.

Again, why don’t we all agree, ahead of time, that when the cost-benefit becomes lopsided, that there will not be any standard insurance coverage to extent the heartbeats of dying people with little hope of further meaningful life? When I ask people I know this question, they vote overwhelmingly in favor of this. As a society, we should draw that line in the abstract, so that those put in this position will have only the option or their own money (or buying a special policy for this purpose). As the above article concludes, “These are discussions that need to take place earlier in life, without a medical crisis looming overhead.”

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Category: Health, Medicine

About the Author ()

Erich Vieth is an attorney focusing on consumer law litigation and appellate practice. He is also a working musician and a writer, having founded Dangerous Intersection in 2006. Erich lives in the Shaw Neighborhood of St. Louis, Missouri, where he lives half-time with his two extraordinary daughters.

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