End of Life Choices

My mother-in-law and father-in-law both have chronic lung disease.  They smoked during all those years when the big tobacco companies were able to produce scientists who denied any link between smoking and lung disease.  My mother-in-law doesn’t always get her medical terminology right (my parents don’t either–they are from a generation that left those things up to the experts).

Recently she told my wife, her daughter, “I’m in the hostage program.”

Sonja corrected her, “You’re in the hospice program, Mom.”

When I saw Maxine last month she told me,

“The doctor gave me two years.  But the good Lord will take me when he’s ready.”  I agreed with her on that.

Maybe my wife is being optimistic, maybe she’s in denial, maybe it’s her experience working in medical records and her familiarity with how medicare works–but she doesn’t take the two years too literally.  She says that prognosis is routinely given for patients needing hospice care, because it is required by medicare.

I still agree that it is in the Lord’s hands.  Maxine’s condition is serious.  She is on oxygen and breathing treatments, and she will never regain the lungs of her youth.  The home health visits, treatments, and meals provided in the hostage–I mean hospice program–are a real blessing.

At some point my in laws were counseled about their options.  A nursing home was one option; the home health care provided by the hospice visits was a better one for them.  They might have wishes for later about what type of resuscitation measures would be used when the time comes.  They will need council and advice from a health professional they can trust.

One of the many proposals that was being considered by congress in the current health care reform legislation was a provision to reimburse doctors for providing this type of counseling.  Opponents of the president interpreted this to mean that he was advocating euthanasia.

I think we do have to be vigilant and consider unintended consequences and possible misuses of any new legislation.  But there is a difference between vigilance and paranoia.  President Obama has not proposed euthanasia as a cost saving measure.  It is not part of his program of health care reforms.  (More from the NY Times.)

Nevertheless, we won’t have to worry about it.  The few senators who had suggested reimbursing professionals for end of life counseling have dropped the provision from their proposed bill.