Health care debate shines light on ‘end of life’ issues

It’s the health care scenario many Americans fear: medical decisions taken out of the hands of doctors and primary care givers, and instead being made by bureaucrats and an overzealous president in Washington; life and death decisions based not on the best medical science, but on the politics of the day; and media coverage that focuses on the spectacular aspects of the debate rather than focusing on the facts.

Yet this scenario is exactly the one that played out in 2005. Yes, long before there was the health care reform debate of 2009, there was the health care debate over Terry Schiavo. Senators and Congressman (most of whom had no medical training) debated the condition of a person they’d never met, but only seen on videotape. President George W. Bush cut short a vacation and traveled back to Washington to sign a bill at 1:11 a.m. And cable news outlets created a “he said, he said” situation asking lay viewers to weigh the arguments made by medical doctors against the misinformation provided by political pundits.

Ironically, many of those arguing most strongly in favor of government intervention in health care decisions four years ago are now the ones spreading fear about that same scenario. Unfortunately, the media is still playing the same tune. For the past few weeks, news outlets across the country are broadcasting and reporting, without prejudice, the false claims that health care reform will result in forced euthanasia.

Any “end of life” debate is an easy target for politics because most of us would rather not internalize the arguments. Though we lead the world in the diversity of our belief systems, far too many Americans simply aren’t prepared for our own deaths.

The most obvious example of this happens every day at our local DMV. People fill out applications for a driving license, and when they get to the check box for organ donation, they squirm in their seats. According to a report card issued by Donate Life America this year, only 38 percent of licensed drivers checked that box.

This should be a no brainer; but when forced to plan ahead for this scenario, way too often the response is a non-response — we’d rather not think about it.

News flash: All of our lives will end in death. And there is only one person who can guarantee that the end of your life won’t be spent in the throes of a national ethics debate: you.

The health care reform bill in Congress is not going to forcefully euthanize anyone. In fact, it makes no mandates about who will even receive end of life counseling — it only says that Medicare must pay for that counseling if it is requested.

According to the bill, “such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy.”

In other words, the bill is doing nothing more than providing counseling that we should all be searching for on our own anyway. (I’d encourage you to find more information at Web sites like those for the Mayo Clinic and the Hospice Foundation of America.)

Everyone needs a set of clearly set care directives in order to spare our family members from more pain and suffering, whether Medicare pays for that counseling or not. And instead of using this debate to sell ratings, the media should use the spotlight to focus on the real issue: empowering us to make our own “end of life” care decisions.

As a Mayo Clinic report issued in late 2005, after the Terry Schiavo debate, said: “Indeed, we believe the press missed an excellent opportunity to educate and inform the general public on matters related to advance directives, surrogate decision making, AFN (artificially supplied fluid and nutrition), and end-of-life care.”

You may not be able to keep the government out of your health care, but you can keep politics out of your death. It’s your responsibility to your loved ones to do so.

Clements’ column runs every Monday on the editorial page.