End of life discussion

This past Saturday, my wife celebrated her second birthday without her mother … a sad day still after a year and half of her passing.   The debate over the end of life discussions has me reflecting on her death experience.

My mother-in-law was a tough lady … double by-pass at age 50 and two more at age 58.  She managed to live 32 years with diabetes and chronic heart disease.    As a small business owner she faithfully paid for her individual health insurance and her Medicare Gap insurance her entire life.  The miracle this is modern medicine allowed her to see all her children grow up and start lives of their own and bask in the love of her five grandchildren.   The daughter of Lebanese immigrants who passed through Ellis Island, she was the essence of the American experience.  Sitti (Arabic for grandmother) was adored by her children, grandchildren, nieces, nephews and siblings.   She had 32 wonderful “Quality Adjusted Life Years” because of the US medical system.

At least a half dozen times in the 25 years I knew her, she was at death’s door yet she defied her doctors by rallying back.  Twice when we lived in Hong Kong earlier this decade, my wife had to fly back believing her mother would have passed by the time she landed.  Instead we had the privilege of her living with us for many months on our return to the US … she was my morning coffee buddy.

During the 2007 Thanksgiving holiday she had her entire family together only to be faced with another medical crisis.   Despite doctors advising that she would not recover, she surprised all again and was back in her home by the new year.  There was something different this time.  She asked her nephew attorney to revise her living will and left very clear instructions that the time had come to not pursue artificial methods to extend her life.   She did not want to die in ICU surrounding by machines and strangers.  Within a few weeks, her mental condition deteriorated and she was back to living with us.   With the support of local hospice services, we honored her wishes.   She refused to take her medicine and asked us to quit bothering with her diabetes care.  After another bad evening (and one son begging to have her hospitalized), the end was near.  She woke up on a Wednesday morning in good spirits, ate breakfast and then told my wife she felt like she was leaving.   Shortly after, she was unconscious and sleeping peacefully.   Her only care was morphine for comfort and the love of her family around her.

At 3 am on March 1, 2008, I checked on her.  Patricia Haddad Van Buren had peacefully passed in her sleep in our house only five minutes earlier at the age of 82.  This is the cycle of life and I can only wish we could all pass with such peace.   While there was sadness at her passing, there was joy at a life well lived.

There is a lot of debate about the end of life counseling in the Democrat’s health care reform bill.  I know absolutely this is code for denial of life saving treatment for those they believe do not deserve further care.  Counseling will quickly become mandates.   My mother-in-law is proof that the greatest medical system in the world can add valuable years of life.   Never do I want anyone to feel the pressure or guilt of a government bureaucrat suggesting that some has a duty to die.

However as conservatives, let us also remember that we all should have these discussions with our family, friends and physicians.  Let us not demonize the importance of facing end of life decisions.   Death is something none of us escape and in the end we must consider the option of embracing how we die as much as how we live.