End of life counseling

Last year my step-father-in-law Bill died of Leukemia. Months later, Mitzi, his wife and my mother-in-law, died of colon cancer. What I think many people don’t know is that when medical personal arrive at a home, they have a legal  obligation to administer medical care. In these cases, that likely means attempting to resuscitate them. They both had terminal illnesses. Any further care would simply prolong their suffering.

After his remission period ended, Bill was ready to go. Being a doctor, he knew how his last days would play out. We discussed the matter and if he could have done so without legal consequences to his survivors, he would have opted to expedite the process. And while Mitzi wanted badly to live another 10 years, she did not want to spend her last 3 months literally starving to death. Protracting the process any longer than nature took would be nothing short of cruelty.

The last thing either would have wanted after their death was a squad of paramedics trying to resuscitate them (unwanted and unnecessary care), hauling them off to the hospital in an ambulance (more unnecessary care), and then storing them in the hospital morgue (more unnecessary care) awaiting their last wishes. To avoid that, there’s a special form that they had to obtain, get signed by themselves and their doctors, and posted on the back of their bedroom doors. The paramedics know to check there, and having done so, they’ll honor the patients wishes.

Providing patients with control over that process is EOL counseling. It helps the patient understand what happens if they make no choices and what other options are available. It provides the patient a process to make their intentions and wishes known to their physicians and the first-responders who arrive at the patients bedside. It is the process by which Bill & Mitzi could relieve the paramedics of their legal obligations and effectively say, “we’ve made other arrangements, leave us in peace.”

It is because of that experience that I have an understanding of EOL counseling. The proposed health care plan provides coverage for EOL counseling to patients. It does not require it. It “covers” it once every 5 years, or sooner if the patients health changes significantly. I’d imagine it could sound pretty scary if a person had no idea what EOL counseling actually was. Especially when the wicked witch of the North is calling EOL coverage “death panels.” Fortunately, even her Republican peers have publicly denounced her fear mongering.