End of Life Debate: Taking a Lesson from the 1960's

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The national discussion on end of life issues is in many ways analogous to the civil rights debate in the 1960's. The topics are different, but both contain similar prejudices, misunderstandings, and fears. In the 1960’s fear of African-Americans led to outrageous claims about their intelligence and humanity. Today, criticism of end of life practices is just as untruthful. Despite the facts, commentators and some congressman claim death panels will be created to determine who will or will not receive life-saving treatment. In the 1960’s as a freedom bus rider in Alabama, I was labeled a “northern agitator” who sympathized with “commies”  and therefore, could be justifiably hated. Today, those of us who advocate for increased hospice counseling and care are called “socialistic” and depicted as people trying to destroy the American way of life. We in turn, just like Barney Frank, feel justified in also using short-hand derogatory terms.

            Ignorance and fear delayed change from occurring in the 1960’s. It eventually did come, but not because the opponents had a sudden change of heart. Instead, it became more painful financially and socially to maintain the status quo rather than becoming more humane. Some believe that despite having elected an African-American president, the process is not complete. If history does repeat itself, we may be at the beginning of a long period of attrition in health care reform, unless there is an understanding of mutual interests that cross political and ideological lines. And that may require looking at death as a necessary part of living, regardless of where one stands on political and social spectrums. Despite our best efforts and most wonderful delusions, we all will die. The questions everyone needs to ask and answer for themselves, are under what conditions, both physically and psychologically, would they like it to occur.

            We hide death away as if it is an embarrassing relative. Instead of addressing the emotional needs of the dying, we focus on when and how to give a terminal diagnosis. Yes, dying is a financial conundrum in health care reform, but, other than our own death, it's also the most spiritual event most of us will ever experience. As a bedside hospice volunteer for seven years, I’ve been invited into the lives of people who were dying. I don’t think there is anyone who has been with someone as they died or watched the compassion shown to them and their families that could be critical of the need for end of life counseling and hospice services.

            I recently appeared on a radio talk show to discuss both of these issues. After I committed to be interviewed I learned the station was unequivocally “far right” in its on-air discussions. I assumed that my interview would be just an excuse for a scathing attack on the health care reform bill. Instead, both the host and the producer of the show where supportive of all aspects of hospice. During the interview, they related experiences their parents had in hospice. Both of these ideological conservatives were fully committed to hospice despite hating the President, the health care reform bill, everyone in Washington, and probably even me if they knew my political leanings. But we were joined by a commonality in what we experienced. Me, serving more than 250 people as they died. They, watching the effects of hospice on their own parent’s deaths. From them, I learned the importance of creating alliances through the commonality of experiences while leaving labels for those who rely on sound bites.

            It saddens me to see one of the richest avenues for learning how to live, framed into political debates involving numbers, timing, and scoring of ideological points. The Buddha said that just as the elephant leaves the biggest footprint in the jungle, so does death when it comes to living. It’s easy to vilify opponents of whatever position we passionately hold. It was for me in the 1960’s when I thought my parents and all of their friends were Neanderthals when it came to civil rights. Instead of trying to understand their fears, I wrote them off as ignorant and refused to hear their concerns. It might be time to take a lesson from the 1960’s and look for commonalities in entrenched positions instead of hurling invectives. People who are facing the end of life without adequate physical and psychological support don’t have 40 years to wait until the debate sorts itself out. 

Hospice in the Bay area:            Pathways Home Health and Hospice

                                                  Hope

                                                  Zen Hospice (Laguna Honda)

                                                  George Mark Children’s House 

Hospice nationally:                   National Hospice and Palliative Care Association

Related Articles                       How to help a loved one die

                                                Aging and grieving

                                                The need for structure in aging

                                                False charges against hospice

copyright 2009. Stan Goldberg, stangoldbergwriter.com. This article can be reproduced and distributed without charge for any non-commercial project if the source is provided.