This past week, health care journalist Charles Ornstein wrote a compelling piece for the Washington Post detailing his personal experience with heart-wrenching end-of-life medical decisions. Ornstein's story of his mother's death highlights the complexity of this little-discussed topic, and should serve as a wakeup call to every American family: End-of-life issues should not be avoided or delayed until the last possible moment. They should be carefully considered and clearly communicated. Even then, as Ornstein discovered, these decisions are never easy or simple.
Americans have always been uncomfortable with the topic of death. We are a youth-obsessed culture, and spend billions each year on products and services designed to slow, stop, or even turn back the clock on aging. On one hand this is understandable. As human beings, we shrink from death because we are beings created for eternity. God created us to rejoice forever in communion with Him, but because of our pride and disobedience, we are separated from our Maker. When we fell, death entered the world, and there's no escaping it. You can hardly blame Americans or anyone else from doing all they can to postpone the inevitable. On the other hand, we too often allow our fear of death to result in a kind of denial. We think if we never talk about death, somehow things will just sort of work out when the time comes. We don't realize that our failure to consider our end-of-life wishes results in unimaginable stress and sorrow for those we love most.
Advance care directives got a bad rap during the Obamacare debates because of a fundamental disagreement over who should be guiding end-of-life care. Proponents of limited government believe that patients in concert with their doctors and families should be allowed to guide the process based on their individual circumstances, while advocates of a universal approach tend to favor standard guidelines and protocols crafted by committee. Apologists would call this "best practices." Critics like myself call it "cookbook medicine." Regardless of what side of the ideological fence you might fall on, however, there can be no denying the wisdom of being prepared.