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End Of Life Isn't a Disease, It's a Fact of Life

'Death panel' dust-up draws attention to the need for more reasoned discussion

By John Boden

September 15, 2009

• End Of Life Isn't a Disease, It's a Fact of Life • Support for Dying Patients Often Lacking --- • More about Aging ...

The feverish discussion about "death panels" and "killing Grandma" may not have done much to advance the healthcare debate but they have drawn attention to end-of-life issues that too often are left until, well, the last minute.

We all die, after all. Sometimes it happens suddenly but often death comes at the end of a long decline that may include heroic, sometimes brutal, attempts to buy a few more days or minutes. The fortunate few die naturally -- perhaps at home with their family, friends and pets nearby. Others do so in hospices, nursing homes and hospitals.

It's not where we die that matters so much but how. Discussions and decisions about the end of life are filled with emotions, questions, uncertainties, and significant consequences. So finding ways to express an idea that will make it easier to be accurately heard and understood is very important.

We have been relying on Living Wills and Do Not Resuscitate Orders (DNRO) as the primary way to describe the wishes for care at the end of life. These documents have been designed, amended, and modified in an almost never ending process. Living Wills are now often many pages long trying to assure that what is being said will be upheld if a dispute should arise. A DNRO is normally only accepted if it is presented on the standard printed format and often only if it is also on the correct color paper. Those providing the care want to assure there will be no variances or potential misunderstandings when they follow their detailed, established DNRO protocols.

This works well for the courts and the healthcare providers, but what about family members who are trying to make decisions at one of the most stressful times of their lives. "What does this all mean for us and our family and what consequences will occur from the choices we are being asked to make?

There is a small but growing movement that is helping lay people hear and understand by promoting the use of the term, "allow natural death."

When I first heard "allow natural death," I got it right away and I bet you do too.

Healthcare professionals still need their definitively defined procedures and lawyers still need their exacting language to win their battles in the courtroom. So be it, don’t change the existing documents, just add "Allow Natural Death" to the titles of the forms and please, when you professionals are talking to us remember it only matters what we hear, so please use "Allow Natural Death" as your lay person terminology.

Ask us if we wish to allow natural death then stand back and let us absorb the concept, and decide what side of the fence we want to be on. We will ask when we have questions, and then you can answer that question, but please don’t lose us in the details.

John Boden, a longtime geriatric care manager, is president of LifeLedger.com, a Web site for family caregivers.

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