Reports on the 5th Anniversary of the Death of Terri Schiavo.
And I was embarrassed that instead of engaging in a thoughtful dialogue about how we die, and how we should die, for several months we were immersed in a shrill shouting match about issues that bear no relation to the reality that my patients and I face every day. In short, as that public debate was unfolding, I felt very much the same way that I felt as the nation watched Terri Schiavo's story reach its conclusion in 2005.
And that reflection is ironic, because the advance care planning legislation that sparked the death panel debate was designed to prevent the sort of family disputes that made Terri's care so difficult. But what should have been an unobjectionable provision in the health care reform legislation quickly became mired in partisan rhetoric and outlandish rumors. A straightforward mechanism to promote choice and autonomy was quickly reframed as precisely the opposite. Looking back on those events, it's difficult to believe that we're any closer to an open dialogue about death and dying than we were five years ago.
In fact, a dialogue may be even less attainable now. As if the "death panel" label weren't destructive enough, recent health care reform discussions have linked end-of-life care to cost-savings and rationing. So whereas five years ago the public was afraid that family members might "pull the plug," now those fears have focused on Congress.
It's no surprise, then, that Congress has shied away from end of life care. As a result, advance care planning was never given the consideration it deserved in the Senate bill and eventually dropped out of sight. In fact, it's unlikely that we can expect any meaningful end-of-life care legislation from Washington in the foreseeable future. End-of-life care has proven to be too divisive, and too politically dangerous.
Labels: aid in dying, end of life care, hospice, martyrdom, palliative care, patients' rights, pvs, terri schiavo
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