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I think you need to see this article.
If you are above 60 Years Definitely.
*If you are in your 30s or Under, MOST DEFINITELY.*
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The New York Times
March 30, 2012
*Taking Responsibility for Death*
By SUSAN JACOBY
I WAS standing by my 89-year-old mother’s hospital bed when she asked a
doctor, “Is there anything you can do here to give me back the life I had
last year, when I wasn’t in pain every minute?” The young medical resident,
stunned by the directness of the question, blurted out, “Honestly, ma’am,
no.”
And so Irma Broderick Jacoby went home and lived another year, during which
she never again entered a hospital or subjected herself to an invasive,
expensive medical procedure. The pain of multiple degenerative diseases was
eased by prescription drugs, and she died last November after two weeks in
a hospice, on terms determined by explicit legal instructions and
discussions with her children — no respirators, no artificial feeding, no
attempts to buy one more day for a body that would not let her turn over in
bed or swallow without agony.
The hospice room and pain-relieving palliative care cost only about $400 a
day, while the average hospital stay costs Medicare over $6,000 a day.
Although Mom’s main concern was her comfort and dignity, she also took
satisfaction in not running up Medicare payments for unwanted treatments
and not leaving private medical bills for her children to pay. A third of
the Medicare budget is now spent in the last year of life, and a third of
that goes for care in the last month. Those figures would surely be lower
if more Americans, while they were still healthy, took the initiative to
spell out what treatments they do — and do not — want by writing living
wills and appointing health care proxies.
As the aging baby boom generation places unprecedented demands on the
health care system, there is little ordinary citizens can do — witness the
tortuous arguments in the Supreme Court this week over the
constitutionality of the Affordable Care Act — to influence either the cost
or the quality of the treatment they receive. However, end-of-life planning
is one of the few actions within the power of individuals who wish to help
themselves and their society. Too few Americans are shouldering this
responsibility.
Of course many people want more aggressive treatment than my mother. And
advance directives aren’t “death panels”; they can also be used to ensure
the deployment of every tool of modern medicine. They can be changed or
withdrawn at any time by a mentally competent person.
But public opinion polls consistently show that most Americans, like my
mother, worry about too much rather than too little medical intervention.
In a Pew Research Center poll released in 2006, only 22 percent said a
doctor should always try to save a patient’s life, while 70 percent
believed that patients should sometimes be allowed to die. More than half
said they would tell their doctor to end treatment if they were in great
pain with no hope of improvement.
Yet only 69 percent had discussed end-of-life care with a spouse; just 17
percent, or 40 percent of those over 65, had done so with their children.
One-third of Americans had a living will and even fewer have taken the more
legally enforceable measure of appointing a health care proxy to act on
their behalf if they cannot act for themselves.
The latter omission is especially disturbing because by 2030, more than 8.5
million Americans will be over 85 — an age at which roughly half will
suffer from Alzheimer’s disease or some other form of irreversible
dementia. For many members of the baby boom generation — more likely to be
divorced and childless than their parents — there may be no legal next of
kin.
Without advance directives, even a loving child may be ignorant of her
parent’s wishes. My mother remained conscious and in charge of her care
until just a few days before she died, but like most women over 85, she was
a widow. My younger brother died of pancreatic cancer two weeks before she
did. It was an immense comfort to me, at a terrible time, to have no doubts
about what she wanted.
My mother drew up her directives in the 1980s, when she was a volunteer in
the critical care lounge of her local hospital. She once watched, appalled,
as an adult daughter threw a coffeepot at her brother for suggesting that
their comatose mother’s respirator be turned off. Because the siblings
could not agree and the patient had no living will, she was kept hooked up
to machines for another two weeks at a cost (then) of nearly $80,000 to
Medicare and $20,000 to her family — even though her doctors agreed there
was no hope.
The worst imaginable horror for my mother was that she might be kept alive
by expensive and painful procedures when she no longer had a functioning
brain. She was equally horrified by the idea of family fights around her
deathbed. “I don’t want one of you throwing a coffeepot at the other,” she
told us in a half-joking, half-serious fashion.
There is a clear contradiction between the value that American society
places on personal choice and Americans’ reluctance to make their own
decisions, insofar as possible, about the care they will receive as death
nears. Obviously, no one likes to think about sickness and death. But the
politicization of end-of-life planning and its entwinement with
religion-based culture wars provide extra, irrational obstacles to thinking
ahead when it matters most.
As someone over 65, I do not consider it my duty to die for the convenience
of society. I do consider it my duty, to myself and younger generations, to
follow the example my mother set by doing everything in my power to ensure
that I will never be the object of medical intervention that cannot restore
my life but can only prolong a costly living death.
Susan Jacoby is the author of “Never Say Die: The Myth and Marketing of the
New Old Age.”
http://www.nytimes.com/2012/03/31/opinion/taking-responsibility-for-death.html?ref=general&src=me&pagewanted=print
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VRU Menon,
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TC VI / 1115, Bennet Road,
Thrissur - 680 020, Kerala
Tel : 0487-233 5252.
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