end-of-life counseling

Ending life on our own terms

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Ending life on your terms | Opinion | The Seattle Times. by syndicated columnist, Froma Harrop.

Being prepared, well in advance of needing to be, will serve you well.

All our lives, we set out on new adventures having prepared for them to the best of our abilities:

  • First day of school;
  • The start of a new job;
  • Preparing for a first date;
  • Wedding preparations;
  • Organizing a Holiday meal;
  • Even something as mundane as putting together a grocery shopping list.
Painting courtesy of Mary Riesche Studios
Painting courtesy of Mary Riesche Studios

We know how to be at our best, and being at our best means painstakingly and carefully preparing for important events in our life.  You didn’t personally have the option of preparing for your birth, but you do have the option, right now, to prepare for your death.

Carpe diem.

What does it mean to end our life on our own terms?  This doesn’t have to be a controversial topic.  I’m not talking about assisted suicide/right to die matters.  What I am talking about, however, is the importance of each of us to spell out in painstakingly and carefully prepared language, all that you want done – or not done – when you are determined to have an irreversible fatal disease.

Death is such a taboo subject.

Why is that?  None of us will avoid the inevitable, but many of us avoid laying down our wishes regarding that final time in our lives.  The subject matter of the attached article relates to medical insurance companies reimbursing medical professionals for end-of-life counseling provided to their patients.  I repeat, this counseling is not controversial.  As Ms. Harrop states, “Critics of end-of-life discussions argue the doctors would ‘push’ patients to end their lives prematurely.  Why would doctors do that?  Where’s the financial incentive in losing a patient?”

The report Dying in America calls on Congress “to end the ‘perverse’ financial incentives that rush fragile patients into invasive medical treatments they’d prefer to avoid.”  That being the case, it seems to me that counseling a patient about their dying wishes hurts, more than helps, the physician’s bottom line, so forget the nonsense about doctors encouraging patients to die sooner than later.  That’s just hogwash.

“Meanwhile, there’s evidence that for some very ill people, a palliative approach may extend life longer than industrial-strength medicine.”  And certainly ones final days without the poison of chemotherapy that has no prospect of curing a cancer, would be far more comfortable than if that therapy had been employed.  “In a study of terminal lung cancer patients, the group that chose hospice care actually lived three months longer than those subjected to hard chemotherapy.”  Again, that would be a more pleasant exit from this life than suffering the ravages of a chemo treatment that is not curative in nature.

“An end-of-life talk with a doctor spells out the options.  Patients can use it as a basis for filling out an advance care directive – a form listing which treatments they would want or not want.”  And let’s not forget that such a document only comes into play if the patient can no longer speak/express his or her wishes regarding their care.  An advance care directive is a legal document and as such, spells out when it can be put in motion, and when it can not.  If ever there’s a time when you can benefit from being a control freak, your final days is it.

This legal document is not just for the older population.

Once you’re considered an adult, you can decide what you want regarding your life.  Don’t wait until it’s too late and someone else decides medical matters without your input.