Ghost in the 'death panel' image

orthopineI opened up my Washington Post this morning and immediately thought about a forum that took place in my own Orthodox parish last night. You see, our priest and an attorney in the congregation led a group of parishioners (many with, I confess, gray hair) through an in-depth discussion of end-of-life planning, with a strong emphasis on points where legal options compliment or collide with our faith's doctrines. It was an enlightening evening.

As far as I could tell, almost everyone there was on board when it came to preparing some kind of document of advance directives to express their own desires about issues such as palliative care, hospices, extraordinary measures to preserve life, etc. It was clear that our church members were anxious to find a way to tell caregivers not to prolong their lives past a point of recovery or meaningful contact with loved ones. However, they did not want to instruct doctors or loved ones to take actions to deliberately end their lives through extraordinary means.

It was an evening for learning how to make intelligent, faithful decisions about complex and emotional issues. It was a night when we learned that centuries of Christian doctrine and practice are highly relevant when discussing what believers have long called "the good death." It was time to talk about final prayers, confessions and a simple pine box.

At the same time, there was another emotion in the room: Many people were worried about the advice and guidance of medical professionals (and the bureaucrats behind them, who guide policies) who do not share their own Orthodox Christian values. And what about the government?

This is where the Washington Post enters the scene, in the form of a story that ran with the headline: "The Unwitting Birthplace of the 'Death Panel' Myth." Here's the top of the story:

LA CROSSE, Wis. -- This city often shows up on "best places to live" lists, but residents say it is also a good place to die -- which is how it landed in the center of a controversy that almost derailed health-care reform this summer.

The town's biggest hospital, Gundersen Lutheran, has long been a pioneer in ensuring that the care provided to patients in their final months complies with their wishes. More recently, it has taken the lead in seeking to have Medicare compensate physicians for advising patients on end-of-life planning.

The hospital got its wish this spring when House Democrats inserted that provision into their health-care reform bill -- only to see former Alaska governor Sarah Palin seize on it as she warned about "death panels" that would deny care to the elderly and the disabled. Despite widespread debunking, those warnings have led lawmakers to say they will drop the provision.

OK, readers, we will not get into debating Palin and what she did or didn't say.

However, if you listen to other voices -- even pro-health-care-reform Catholics -- you will find that there are people who wonder about President Barack Obama's love of "independent" experts who help guide government policies on end-of-life decisions that involve "quality of life" questions, the elderly and, yes, cutting costs. Here's the New York Times quote (drawn from a recent column I did on the subject) about that looms over the constructive discussions of this:

"That's where I think you just get into some very difficult moral issues. But that's also a huge driver of cost, right? I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here," said Obama, in a much-quoted New York Times interview.

"I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. ... That's part of why you have to have some independent group that can give you guidance."

Now, this new Post article contains all kinds of interesting information about a hospital that appears to be doing good work in this area.

resurrection_icon_critical_cutWhat's the problem? The problem is that the article is haunted. The Post team seems to think that there is some way to discuss these issues in the context of North America without religion getting into the mix. Simply stated: Do most Americans, or even a large percentage of Americans, want to turn to government leaders, insurance executives and medical personnel -- alone -- when they make decisions about how they want to die?

In the Scripps Howard News Service column I wrote on this issue recently, I talked with John Haas, president of the National Catholic Bioethics Center and a member of U.S. Conference of Catholic Bishops task force on health care. His question: Could there be some way for the health-care-reform package to provide vouchers that would allow Americans to make their own decisions about where to take these questions?

Journalists! Think about this. The Post story seems to assume that it is in the government's interest to either push or steer people toward secular institutions when it's time to make decisions that involve their most personal religious beliefs. Perhaps most Americans would prefer to face these ultimate issues with help from their own pastors, rabbis, priests, hospice workers and other religious counselors?

Here's what Haas had to say:

"The Catholic Church has a highly developed body of teachings and traditions to help guide people through these kinds of decisions," said Haas. "We believe that hospice care is normal and good. We believe that it's right to die a good death, with an emphasis on the relief of pain and suffering. ...

"But let's be clear. We think the government has an agenda on these kinds of issues and it's not the church's agenda. When it comes to dying, controlling costs is not our primary goal."

The Post article contains lots of interesting and completely valid information. That's good. There is a major story here.

But how do you write an article about end-of-life decisions without even mentioning the religious side of this equation? Does anyone else see the ghost here?


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