Preparing for Death, Responsibly

In a recent New York Times article, the author discusses the comfort she received from her mother’s explicit instructions regarding her end of life care during her mother’s health decline and eventual passing. The author’s mother opted to live her last days in a hospice room at about $400 dollars a day as opposed to staying in a hospital that would have cost Medicare over $6,000 a day. Although the author’s mother was concerned with comfort and dignity, she was also relieved that she would not leave loved ones or Medicare with high medical bills after she passed.

Currently, one third of the Medicare budget is spent on end of life care, and a third of that budget is spent during the last month of life. If more Americans were to write living wills and appoint health care proxies while they were still healthy enough to do so, the high medical bills spent by family and Medicare would likely decrease—but too few American take on that responsibility.

Some Americans wrongfully believe that advanced directives take away the possibility of aggressive treatment, but these legal documents can also be used to ensure every tool of modern medicine is used to maintain life for as long as possible. According to a public poll, however, most Americans are more worried that too much medical intervention will take place, even after all hope for improvement is lost.

In a 2006 poll released by the Pew Research Center, 22% of those polled believed a doctor should always try to save a patient’s life, 70% believed a patient should sometimes be allowed to die, and 50% stated they would tell their doctor to end treatment if there was no hope of improvement and if they were in great pain.  However, only 69% had discussed end of life care with their spouses, and only 17% had discussed end of life care with their children.

Not only can advanced directives give a patient comfort from the knowledge that his or her wishes will be followed, they can also give a child comfort in knowing that he or she is following the parent’s wishes. As stated by the author of the New York Times article, “My younger brother died of pancreatic cancer two weeks before [my mother] did. It was an immense comfort to me, at a terrible time, to have no doubts about what she wanted.” 

See Susan Jacoby,Taking Responsibility for Death, The New York Times, Mar. 30, 2012.

Special thanks to Naomi Cahn (GWU Law School, John Theodore Fey Research Professor of Law) for bringing this article to my attention.