“Pulling the plug on grandma????” Please! Give me a break. What is being discussed is a process that most good physicians already do as part of patient care. The issue is not about ‘pulling any plug’. It is an issue about pride, dignity, choices, and the rights of patients to know the condition of their health and the pros and cons of treatment options. The part of the health care bill that is alleged to give this “pull the plug” scenario life is one in which the doctors that are doing this can get paid for the time they spend.
For the patient and family, it means that they will have an opportunity to choose to obtain information as to various treatment options available and how it will affect them. Then, the patient and family can make decisions based upon knowledge rather than guessing.
Many years ago, while working as a paramedic, I responded to a call where an elderly woman had fallen. She couldn’t get up and her spouse was unable to help her do so. Although she was not seriously injured, we patched up a few scrapes and transported her to the hospital for a thorough checkup. The spouse spoke with me for a few minutes before we transported his wife and the words he spoke have been etched into my brain. With tears running down his face he said: “This ain’t living, they’re just keeping us alive with all this medicine, but it ain’t living. This is Hell.”
I sat with him at the Emergency Room for a minutes before I had to get back on the road. He spoke to me of his concern that despite having living wills, if something happened to them someone might ignore it or fight to have extraordinary measures that neither he nor his wife wanted to have used on them. He said that he had lived his life with pride and he wished to leave it the same way. He added that neither of them wanted to be stuck on a bunch of machines and be just lumps. Nor, did he want to be filled with medicines that kept him breathing but unaware of what was going on around him.
Over the years, I met other patients that wanted to hang on to every possibility in hopes that something would change. They did not care what medications, machines, or anything else was needed to keep them alive.
What the bill being discussed offers is an opportunity to make sure that people with terminal illnesses have an opportunity to understand exactly what the process holds for them and allows them to make choices about both quality and quantity of life. It does not promote one of those over the other, rather it provides an opportunity for patients and families to work with physicians to make sure that the wishes of the patient are known, and family members will be aware of what to expect.
In the decades since I went on the ambulance call noted above, I have had friends and family members where these discussions with health care providers have occurred and decisions have been reached. Although the choices have varied, the ultimate outcome was consistent. The patient and/or family members were provided with information that helped them to understand the process and to have realistic expectations. Decisions were made, removing unnecessary stress, and creating an environment where a loved one’s last days, weeks, months, or years were as comfortable and productive as possible.
Other situations have arisen where these discussion did not occur and people were not prepared to deal with situations. Stress and frustration grew and became the dominating force for those whose lives were involved in the process. Later, there was regret for time lost feeling fearful or helpless that could have been quality time spent with a loved one if they had better understood what would be happening.
This really isn’t about pulling the plug on anyone. It is about the right to make choices in treatment. It is about the right to have the knowledge necessary to make conscious decisions about how you wish to spend the last of your life. Where the patient is unable to make that decision, those loved ones who will make the decisions need to have every bit of knowledge available in order to honor the wishes of the patient and to make decisions that they will have to live with. The process is about informing…..the deciding remains in the hands of the patient or (where the patient is unable to make such decision) in the hands of loved ones.
Something so personal and private should not be used as a tool by politicians or insurance companies to try to instill fear. It is not something that should be used as a weapon, generating the type of anger and abuse that is being shown on almost every news cast. Something that should be faced with grace and dignity should not be distorted as it has been during these discussions. This type of psychological abuse, promoting and encouraging fear, is just wrong.
If you want to know more about this topic, don’t go to politicians or insurance company representatives for information. Take the time to call someone at a local hospice center or give your own physician a call, or ask a social worker. Talk to those with the experience and the knowledge to give you an answer that will be influenced by the experiences they have had with patients.
For some additional information on the Health Care issue, you might want to check out the League of Women Voters of the United States.
