It is well known that an extraordinary amount of medical care is applied during the final months of life as major – and multiple – parts of the body begin to fail.
The medical community operates under the principle of working to keep us alive, and it is good at that. But as we know, the time that is gained is sometimes of questionable quality.
Deciding what constitutes “life” should be more than an academic exercise for us all. Unless you collapse without warning at or near the apogee of your time on Earth, deciding what you want to happen in those final months is important. Have a session with your loved ones and your doctor, perhaps including your attorney, and decide just how much medical intervention you want under what circumstances. Without proof of those decisions, the default for a hospital and for family members, who may not know you very well, is to maintain life-supporting efforts.
End-of-life decision-making was the topic of a Mercy Regional Medical Center conversation this week. Following the model of an Oregon Council on the Humanities participatory program, the 40 or so Durango participants gathered in small groups to describe successful and less-than-successful end-of-life situations they had witnessed. These included missed opportunities to share an experience, to reach out to say “I love you” or “Thanks for your friendship” and, on the other hand, conversations and events that successfully brought closure to relationships.
For the over-60 age group, the subject was a popular one; everyone was eager to talk. It was also clear that people feel differently. Some want to die with loved ones and friends present, others do not. There was laughter at the suggestion of organizing a going away party now. Almost universally, the desire was to die at home or somewhere other than at a hospital.
While perspectives varied, the overarching message was how everyone can be prepared. Make your feelings known about events you want to occur and people you want to be involved if you are incapacitated in some way at your death.
While health care intervention might be most important, your family will thank you for preparing a will, a list of assets and advanced directives and for itemizing what you would like to see in your obituary. For those who will collapse at some unpredictable moment, much of this still applies, especially estate issues.
Death is not just a possibility. Not everything associated with it can be predicted, but much of it can. For everyone’s benefit, be prepared.
Last November, Colorado joined five other states in passing medical aid in dying legislation to make it possible for terminally ill individuals (with six months or less to live) to acquire life-ending medication from a doctor. The vote in favor was fully one-sided, 65 to 35 percent. The protections – that two doctors must be involved and the individual must be of sound mind and able to self-medicate – were deemed reasonable.
There are rumblings, however, that some in Congress favor challenging states’ power to pass such legislation. The District of Columbia, which approved aid in dying legislation, but is to some degree governed by Congress, is currently being challenged by the House Appropriations Committee that voted recently for a spending bill containing an amendment that would repeal D.C.’s law. If it moves on, it could pose challenges to similar laws in other states. Another effort to amend the federal Controlled Substances Act is underway to make it illegal to use any substance on the list for medical aid in dying.
Those who believe that aid in dying should be possible, and should remain a state decision, should be alert. The laws are well-conceived; it should be an option for those who desire it.
Congress should back off.
