Who Wants A “Democratic Conversation” On Death?

posted at 2:54 pm on August 17, 2009 by Laura Curtis
[ End of Life Issues ]    printer-friendly

One statistic in the health care debate that is incontrovertible is that the mortality rate is 100%.  The real questions, since we’re inevitably going to die, is in what manner and who gets to choose it?

The President thinks we need to have a conversation about this.  One “guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.”

As usual, he displays naked arrogance.   Here’s a little newsflash, Mr. President: America has been having that conversation all along, and without the benefit of your input.   Every family at some point struggles to deal with amazing – and expensive – medical advances that extend life and with our inevitable mortality.  In my family, those conversations have had two very different outcomes in the past few years: for one, the family member empowered to make the decision chose to withhold food and water from someone when she reached the end stages of terminal cancer, in order to hasten her death.  She died in the hospital, which was perfectly agreeable with this plan; the doctor actually suggested it.  In the other, the patient himself decided to receive food and water only so long as he could take it by mouth; no feeding tubes or IVs for him!  He died in his own bed at home.

A “democratic conversation?”  Hardly.  There was nothing democratic about this.  The family didn’t vote, and certainly no outsiders had, or should have had, any input.  Everyone didn’t agree on the best course of action, but what I can promise you is that there was no political channel, normal or otherwise, that could possibly have improved those situations.  Terri Schaivo’s situation notwithstanding, the vast majority of families in this country are perfectly able to resolve disputes among ourselves.  We do not require or want government involvement.  For families that do, let them duke out in court who gets to decide; for the sake of those few, we do not need a law that affects us all.

Guidance?  I don’t want guidance.  From doctors, I want information.  From scientists, I want research and new medical advances.  And ethicists can stick to their cosseted, insulated, ivory tower lives and stay out of mine.  Or better yet, get a real job.  As for government – who presumably would organize and guide these “democratic conversations” about who gets voted off the island- surely it has better things to do than micromanage our deaths?

If the government ran neutral PSAs encouraging people to consider what they want in end of life care, I’d support that wholeheartedly.  Seeing these illnesses played out in our immediate family has certainly provoked my husband and I to make our own decisions so no one else will have to – the Engage with Grace project was a useful tool.  What I do not want to see is legislation of any sort.  It’s one thing to say, “I want to die at home,” and quite another to be told “Go home and die.”  And no matter how gently prospective legislation may “guide” us, it will still have the force of law behind it.  Once such a law is implemented, it’s easy to imagine future amendments steering us more in whatever direction the current administration wants us to go.  Laws are directives, not conversations.  Anyone who’s ever dealt with government bureaucracy knows that today’s “guidance” is tomorrow’s “death panel.”  As Althouse wrote:

Conversations! Damn! As if the government does not have power! Oh, but it’s “not determinative,” you say. It’s just “some guidance.” He said that, see? Ugh! Spare me! We’re right to be afraid now, while the man is burbling about conversation. You know damned well he’s about to say and now the time for conversation is over, and we must pass legislation. Before, he was all quick, shut up, it’s an emergency, pass the legislation. People freaked, so then he deemed the period of freakage part of the conversation, and there, it has occurred, and now: shut up, pass the legislation.

Soon it will be my turn to be the decision maker.  It’s sobering, terrifying.  I’m seriously in doubt about my wisdom in this matter.  What I do not doubt is that I can make a better decision for myself and my family than any government official or committee.

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