I see nothing odd in the government having interest in end of life counseling. I seem to remember fervent government interest in the sad case of that poor woman in Florida (forget her name now) whose husband refused to let her parents care for her in the absence of documentation of her own wishes. If there’s a way to perhaps prevent repeat of such a tragedy, why would the people with the authority not exercise it?
You mean Terri Schiavo? I guess you do. That case is troubling on a number of levels. But I don’t think it’s a stretch to think of it in terms of how ready some are to terminate a life based on the flimsiest of “expression of wishes”. As I understand it, she was starved and dehydrated (I guess she died of thirst in the end) based solely on her estranged husband’s assertion that she had said something to the effect that she wouldn’t want to “live like a vegetable” or something of that nature. And the judge accepted that as a basis for actively killing her. Then, of course, all sorts of people argued this and proposed that, and so on.
Now, when we think about well persons and expressions of their “end of life” wishes, how sure are we that well-considered (let alone religiously based) statements are going to be made upon encouragement by some physician (more likely nurses, NPs or “counselors” of some sort) to make some kind of statement, considering that none of the interlocutors are going to have any idea at all what the well person’s “end of life” conditions are going to be like, and further considering that the interlocutors’ views about it are going to differ as much as anyone else’s?
This very day I had occasion to talk to a couple who I would say are in their fifties somewhere. Both at least appeared to be healthy, and claimed to be. The woman told me (and her husband confirmed it for himself) that they are leery of the whole subject. The woman admitted that, at fifty-something, her thoughts about what she would want or not want are very different from her thoughts about it at age thirty. She expressed that she did not know how she would see it if she was 70. I hazarded that her thinking about, say, CPR at age 70 would likely depend on how healthy or unhealthy a 70-year-old she turned out to be, and why she needed CPR in the first place. Both of them agreed with that.
Now, some might say that demonstrates the merit of older people having annual “end of life conferences” with whoever it is that turns out to actually deliver the “service”. But I am inclined to think the whole situation can turn around on a dime and that well people can have no reasonable guidance at any age because they cannot address specifics of care and can only make very general declarations.
Now, when one makes general sorts of declarations (and I have seen many) they are almost always sufficiently ambiguous to allow the treater to impose his/her own philosophical or moral leanings on them. They can’t be anything else, because the well person can’t address an unknown condition or unknown methods of treatment with anything resembling precision the way, say, a person with pancreatic cancer or congestive heart failure or third stage renal disease can. But those persons are necessarily going to be counseled by their physicians anyway as to the course and outcomes and methods of treatment, without any new government program.
Because treaters vary widely in their views of the “value of life”, ambiguity and imprecision can be deadly. Now, if a “living will” prepared in the only ways a well person can actually prepare one (with generalities) is presented and encouraged in the medical setting, it will become part of a person’s chart just the same as it will if presented to a doctor or hospital directly. From that point on, the generalities essentially leave a lot up to the mores of the practitioner, and there is no particular reason to believe such people will have any greater respect for life than does, say, Kathleen Sebelius.
I mentioned being involved in a seminar for medical people; future practitioners being trained in two universities and one technical college, and also people studying in the social service area. It was very obvious that beliefs about what should motivate a termination decision vary widely. Most appalling to me was the expressed belief by not a few, including the physician panelist, that religious precepts have no place in the process at all. Keep in mind, those are the very people who will, in the future be among the “end of life counselors”.
It is inconceivable to me that placing this whole question into secular hands and providing “counseling” by people who have very different beliefs about the most basic of things, can be anything but morally chaotic in application. And to me at least, while getting the government involved in it seems so important to this administration that it ignores congressional rejection of that involvement, I do not have a good feeling about it at all. Is urging on people decisions how one ends one’s life really a proper function of government, or is it simply the reflection of an ideological position of those in power? It’s very hard for me to believe it is not the latter.
