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Continued: End-of-life costs force painful decisions about death

  • Article by: SALLY KALSON , Scripps Howard News Service
  • Last update: April 17, 2013 - 1:35 PM

We went around like this a few more times. Clearly, this woman did not want to die, period, and who could blame her? We dropped the living-will idea and kept visiting her in her apartment, the hospital and then the nursing home.

Down the hall was another elderly woman who wailed in agony at regular intervals, day after day. An aide said the patient was reliving childbirth on a continuous loop.

I looked at my husband and said, “If I ever get to that state, shoot me.”

“Too messy,” he said.

“OK, overdose me. Or get me the drugs and I’ll overdose myself.”

We weren’t entirely joking, having thought more than our fair share about the possibilities of my demise. Living with cancer will do that to you. Most of the time, when I’m in remission and feeling good, it’s off the radar. But every time it comes back (three so far), I have to consider that it could be the beginning of the end. I don’t want to die, but I don’t want to suffer either. And while I’m all for prolonging my life, I’d rather my death be a quick one.

Or, as my older brother put it, “The best thing is to go to sleep and wake up dead.”

My cousin grew progressively weaker and needed more drugs for her pain. We called in the hospice to keep her comfortable and took turns at her bedside. She’d sleep fitfully and awaken with a start.

“I’m afraid to go to sleep,” she said. Of course she was. It might mean waking up dead.

Which, finally, is what happened. She died overnight; her fear and suffering were over. Extraordinary measures never came into play. But they might have. What would we have done? Could we, in good conscience, have withheld heroic measures, knowing she wanted them, but also that their exorbitant cost would serve no meaningful purpose?

Many of us may have to answer this question at some point. Health-care rationing sounds evil, but the fact is, we’re already doing it, based on who’s covered and who isn’t. Our challenge is finding a way to provide the best care at the lowest cost to the most people by the most efficient means.

But when I think of Terri Schiavo’s brother, and the nation’s Republican governors, and my cousin, I have to wonder if we’re up to it.

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