We are Mortal - Grow Up and Plan Accordingly

The Senate Finance Committee may strike end-of-life consultation reimbursement from their version of the health care bill, so maybe the hysteria will die down. But it's sure to rise again if the provision survives in the House version. Will Congressional leaders summon the courage to deliver an adult response or cave in to hysterical attacks?

It's remarkable how easy it's been to gin up a frenzy of fear and anger with scary messages that remind people death is inevitable. Most politicians say they support advance directives for end-of-life planning and encourage their use. At least they did until a few days ago. That's when the idea took hold that it's highly dangerous and tyrannical to encourage doctors to talk with patients about what kind of treatments they would want if they were terminally ill and unable to speak for themselves. That's why the provision to reimburse doctors for the consultation can't be part of health insurance reform. Apparently this would be the first step to a Nazi regime, where doctors somehow profit from euthanizing their paying patients and panels meet to decree the death of granny and disabled children.

The national dialogue leaped from modest proposal to outrageous hyperbole so fast it's clear something profound and quite apart from advance directive consultation was at work. International professionals in end-of-life counseling joke that in America people think death is optional. It certainly seems true, to judge by the public's tantrum after being reminded it ain't so.

Hello America! We are all mortal! God made us that way. Adults know this in their hearts and the wisest among us live every day conscious of life's impermanence. A mature society would have handled this differently.

One of my favorite poets, Edna St. Vincent Millay, wrote, "Childhood is the kingdom where no one ever dies." Apparently that's the fantasy some of our national leaders want to promote. "Terry Schiavo will be kept alive even if it takes an Act of Congress!" "No one need ever discuss with their doctors how their life might end." Such attitudes treat American citizens like children, too young to come to terms with their own mortality. Why should we be surprised to see town hall displays of childlike temper tantrums? Treat people like children and they will act like children.

Playing into America's pathological denial of death is to treat mature individuals like children, and very young children at that. Researchers and clinicians tell us it's normal for children 3 to 5 years old to deny death is final. Telling a very young child Granny is "asleep" or "on a long journey" supports the denial. Between five and nine years old children come to accept that death is final, and can think about it's happening to others. By about age ten a child is usually ready to start thinking about her own death.

National leaders deliberately sparked fear and anger over a consultation about death and sensational media threw fuel on the fire. They would have us remain a nation of five year olds, stuck in an infantile refusal to acknowledge, grieve over, and plan for, our own deaths or the deaths of those we love. For shame. Certainly that's no way to come into our greatness as a nation. Certainly such stunted psychological and spiritual development is not what it means to be a human, created, as many believe, in God's image.

No, coming into the fullness of being means living a life of thoughtful judgment and conscious decisions. And that includes decisions about the end of life. Recently the New York Times carried a story of the care and intention with which the Sisters of St. Joseph manage the individual deaths of their aged nuns as the entire order gradually dies out. They are thinking about their dying and they are talking about their decisions. "We approach our living and our dying in the same way, with discernment," Sister Mary Lou Mitchell told the reporter. "Maybe this is one of the messages we can send to society, by modeling it."

In Adulthood -- a kingdom still distant from our shores -- leaders will foster dialogue and pass laws to help their constituents on that very human quest to discern and embrace both life's sweetness and death's certainty with a similar quiet grace.

Comments

[Northernview]

Incredible.

Where were Beck, Limbaugh, O'Reilly, Savage, yada yada yada, when Bush was "elected" by the Supreme Court, used lies to drag the US into an unnecessary and brutal war, then swept away nearly 800 years of habeas corpus, authorized torture and warrantless wiretapping, etc? Were they yelling about "Nazis" or openly speculating about assassination? Of course not, because Bush is a white Republican.

But just try to bring health care to all Americans and suddenly they're on the warpath, and given full voice by the networks that help them spread their lies. Pathetic, slimy, cowardly hypocrites, all of them.

[Chitownfool]

Man I'm gonna live for ever! But if I do die I'm gonna smack god up side the head and tell him to go get me some tacos! And if he says something I'm gonna be like "what god? WHAT? DO SOMTHIN!!"

[Dem02020]

If this particular provision is being successfully used to 'demonize' the whole Bill, and thereby threaten our chance at Public Health Insurance, then maybe it should be dropped for now, and brought back later (soon), separate from reform that includes Public Health Insurance.

Why make it easier for opponents of Public Health Insurance to defeat that urgent reform, by attaching to it the easily misconstrued and far less universal 'end-of-life counseling reimbursement provision'.

Make the debate harder to confuse and misconstrue, by making it simpler and more fundamental.

Public Health Insurance... and 'end-of-life counseling reimbursement'?

Sure, we can do that too, but let's prioritize the debate and keep it focused.

Why allow "death panel" nonsense to confuse the debate just now, why not treat that important matter separately, right after we pass a Public Health Insurance option.

There are two important things we're trying to do here:

1. Enroll the uninsured and those who find private health insurance too expense and too consumptive of their moderate incomes, enroll them in Public Health Insurance...

2. And reduce health care costs.

Of those two things, you always enroll people first, and then attack costs second.

It's the only way to build the political capital and consensus necessary to reduce costs, to first get people into Public Health Insurance... to try and do it the other way around, to try and reduce costs without having the insured on your side, is an impossibly hard thing to do.

[Hawkman4]

On the American report card:

Prone to temper tantrums.
Unwilling to share -"I want my country back"
Speaks before thinking.
Unwilling to learn.
Cheats, steals and then blames the other students.

[Yatzak]

Thank you. Well said.

[sixyfivepercentwater]

Whether the dialogue is covered by insurance or not, we all need more information about what it means to age and how to plan for and deal with the inevitable. Death is the one taboo subject: people would rather talk about how much money they make than talk about death.

The effects of aging come as a big surprise to some of us. Gradually but undeniably, we are unable to do things we once did effortlessly. Pain visits us and sometimes moves in and doesn't pay rent. Our bodies change for the worse and keep changing. That is what aging is about.

We certainly do need to plan for the effects of aging, chronic illness and death, because they are going to happen. There is no point in not discussing it with friends, family, and doctors. Ignorance is not bliss: it's just a lack of information, which doesn't benefit anyone.