Love & Let Die

Friday, May 31, 2013

Lawrence Weschler, director of the New York Institute for the Humanities at NYU, and Diane Meier, chief executive officer of the Center to Advance Palliative Care (CAPC) and professor of geriatrics, internal medicine and medical ethics at Mount Sinai School of Medicine, discuss Saturday's symposium exploring the question of prolonging life in an era of limited resources.



Diane Meier and Lawrence Weschler

Comments [25]

Charlotte from Sunset Park, Brooklyn

How many times do the guests have to repeat themselves? They are not talking about death panels. They are not talking about death panels. Brian, hey, the guests are not talking about death panels. Over here, read. They are talking about the very last months of life and the high costs of that kind of extreme care because their only option is the emergency room (no hospice, palliative, pain care available, or prohibitively expensive). This is not sensationalist journalism, nor a sensationalist program, so please don't keep insisting upon a logical fallacy. Listen to this program on NPR:

Jun. 03 2013 02:43 PM
Ed from Larchmont

I think you have cause and effect upside down here: the Catholic Church preaches to the whole world. In general, the wealthy nations are too distracted to listen. The poor, generally, are more aware.

Jun. 02 2013 10:45 AM
Gail from Fair Lawn, NJ

On February 22 I was watching a DVD in my nightclothes when a county social worker arrived at my home and told me that it had been reported that I was suicidal! I said that was absolutely untrue, but in answering her list of cookbook questions I expressed my opinion on the Right to Die and told her about a friend who at 81 was losing her sight and had serious finacial difficulties. She flew from NY to San Francisco and jumped out of a hotel window to her death. She was highly independent, intelligent, articulate, well-traveled and sociable, and although this was entirely unexpected I could understand her thinking, but in telling this tale I earned myself an involuntary trip by ambulance to a psych ward for an evaluation! The police even threatened to handcuff me and carry me out the door. To add insult to injury, although I was discharged at 1:30 a.m. and walked out in the snow in hospital socks because I left the house barefoot, Medicare was charged hundreds of dollars for the ambulance and a slew of unnecessary lab tests! I'd better shut up next time someone wants to know what I think of end-of-life planning!

I have both multiple sclerosis and Parkinson's disease but have never experienced any depression. I deal with these chronic and progressive medical conditions in as practical a way as possible. My joke is that the good news is that I'll live a long time, and the bad news is that I'll live a long time! I have no children or family nearby and am very interested in knowing what other people are doing in my situation. I plan to stay in my home right up to the end.

Jun. 01 2013 11:56 AM
JW from Chelsea NY

My grandmother just passed away last January at the age of 101. She outlived her money, and had to leave her assisted care apartment and move into the nursing home part of the facility when the cost of her in-home care became prohibitive. She died in hospice in the nursing home.
I am now in that terrible sandwich of having aging parents still in their own home, still driving(daytime only)and fairly independent, but increasingly frail, and having a teenaged son who needs my attention. My brother also has young children, and neither of us live near our parents. I am just waiting for the terrible phone call about an accident or stroke. They have made it clear they want to die in their home and not "be a burden."
Our youth-obsessed culture wants to turn away from the reality of aging. 50 is the new 30, we are perpetually striving to be ever younger. We have ignored this incredible resource of still vital elderly people-and the business opportunity of pairing unemployed teens and college age or grads and the elderly-the term "wisdom of the aged" is almost never brought up anymore. And the vitality of young people is what the elderly often miss most of all.
We ignore this because our culture is in denial. The Boomers do it at their peril. I only hope, as one of them, that we have the critical mass and energy to create a new model for this next phase of life, which can be a rich experience for all if we so choose.

May. 31 2013 11:51 AM
elsie from Brooklyn

to Ed from Larchmont

If Catholic morality is so concerned with taking care of people then why are Catholic countries typically nations with large numbers of impoverished people?

The denial you have to engage in to believe that Catholicism cares at all about anything other than power and money is shocking.

May. 31 2013 11:38 AM
Christine Brown from Millington, NJ

I just want to say two things. I am 48 and if I ever have Alzheimer disease, I would not want to live further after I have forgotten everything I ever knew. My girlfriend's mother literally forgot how to walk, and they were still giving her blood pressure medicine etc.

Also, my father-in-law had a quadruple bypass after being helicoptered to another hospital. He is 70, an alcoholic and has smoked 2-3 packs of cigarettes a day his whole life. He was fixed up and sent home without any support to stop smoking or drinking. Of course now he is back to smoking and having beer for breakfast. He could get all the surgery he wanted but no smoking cessation or nutrition program......

May. 31 2013 11:34 AM

We need to ensure that civilized home hospice care is covered for and available to everyone.

May. 31 2013 11:29 AM
Amy from Manhattan

Ed, what was distorted into a portrayal of "death panels" was a provision that would require insurance co's. to pay for an app't. for a patient to have a discussion w/a doctor about end-of-life care & what each option would entail *if the patient requests it*--not imposed by the law. That's basically what John A says he wants.

May. 31 2013 11:28 AM

Ed, "death panels" already exist in the form of private insurers. How on earth can someone other than your doctor justify approving medications or treatments? It's not as if they're sitting in on my appointments via Skype.

May. 31 2013 11:27 AM
Anonymous from New York

I find it hard to be optimistic that we are going to work towards improving quality of life in death when that doesn't happen at any other point in our lives currently. Most Americans don't have the quality of life people have in other advanced countries and I don't see that changing anytime soon, unfortunately.

May. 31 2013 11:24 AM
PhillipeNYC from Brooklyn

This discussion is definitely worth having. People who feel that they have reached the end and freely choose to save their families the financial burden should have the option to do so without consequences to the medical practitioners they select to help them.

However, it is a heart-wrenching decision. But it is not a new discussion to the human race since other cultures practiced these options in various methods. See the 19th century Japanese portrayal in the amazing 1983 Japanese film called "Ballad of Narayama'. The film portrays this as a tradition that most of the elders expected and accepted. Hopefully, we will never practice it as exemplified in 19th century Japan. See some of the film details via this wiki link:

May. 31 2013 11:21 AM

Ed there are no death panels.
If insurance doesn’t pay for treatment there is always charity care or ones savings, for those who want to live a few more weeks.

May. 31 2013 11:21 AM

I had all these discussions with my parents, before they both died (at separate times) in 2005. I had power-of-attorney and medical POA as well. All was quite smooth, easy, what they wanted discussed, carried out. Good deaths, both ... tho' quite different.

May. 31 2013 11:20 AM
Paul from NYC/Northern NJ

Life planning, great idea. You presuppose that 1. people are that organized (I am smart enough and make a living, but have issues with these things myself) and 2. that many more people have TIME to do this, being squeezed to "death" by stagnant low wages, un- and underemployment, and the ever-increasing cost of things.

May. 31 2013 11:20 AM
Amy from Manhattan

We keep people alive longer *so we can torture them*? That's a hell of a way to see it. It's the other way around: we use treatments that *in some cases*--not even most--can been seen as amounting to torture *so they'll live longer*. I think Mr. Weschler is exaggerating the proportion of cases in which care meant to extend life becomes "excruciating." He also doesn't seem to take into account the possibility that further advances in medical care might permit us to extend people's lives in ways that are less painful. (BTW, once someone has had both hips replaced, why would they need 3 more hip operations?)

May. 31 2013 11:20 AM
Liz from Glen Cove

My mother always talked about a "good death when the time comes," but was indeed tortured at the end stages of kidney disease last year. This happened because the "time" never came. The overwhelming will to live kicked in at age 80. Also, the option of making her comfortable and discontinuing treatment was never made available to her or us, I realize now that we needed to pursue it - it wouldn't be offered. I am forever haunted by the fact that she died hooked up to the dialysis machine and in terrible pain. I wish I could have helped her achieve the kind of death that she wanted, and feel that I failed her.

May. 31 2013 11:19 AM
Rich from Ridgewood, NJ

My first exposure to the last year of life was with my father. His ICU costs, medical mistakes etc., cost more than his lifetime earnings and he could not leave a bed for more than 12 months. My mother, conversely, died quickly, but not without a $100,000 last week of life bill for services rendered that everyone knew would not work. The costs are obscene. I hope not to put my children through it.

May. 31 2013 11:18 AM
Christine from Westchester

To RJ: I have to disagree with you. I think some of the poor might be better off not being "treated to death." I've worked as a paramedice alot of years. I found that the pooerer folks had a better plan and acceptance for the death of terminally ill members of their family. They didn't die tethered to machines in an ICU. They died comfortably at home with family. I'd prefer that personally. Hospitals no matter who comes in will treat them with every thing they can think of, not making you better but prolonging the agony.

May. 31 2013 11:17 AM
carolita from nyc

I have always reserved the right to check out early instead of living in pain and spending ridiculous amounts of money to stay alive. In my family, ever since the Quinlan case back in the 70s (I'm showing my age) the mutually rule between our parents and us (both ways) has always been "pull the plug!"

May. 31 2013 11:17 AM
antonio from baySide

I am 41. What we should be doing is trying to get everyone off what appears to be solutions that don't work..
Example I have acid reflux; My doctor gave me a medication to help, however it's not curing me AND he revealed it's almost certain the drug causes calcium degration (albeit decades later, but still)..would lead to fractures in old age...
What happened to drugs that CURE disease; Answer BIG PHARMA, theres no $$$ in healthy...

May. 31 2013 11:16 AM
Jennifer from Westchester

Maybe there should be two insurance systems-one for people who believe in taking every possible measure to save lives-and are willing to pay for it, and one in which we are allowed to decline extreme measures to save lives in futile situations-and those do not have to pay the huge bills for beginning and end of life care that can be avoided by letting nature take it's course?

May. 31 2013 11:15 AM
John A from 20+ years yet.

Be bold with this. Saw both parents off and I would like the euthanasia option for myself when I reach a certain level of decrepitude. I want to be my own legal death panel.

May. 31 2013 11:14 AM
Nat from NYC

Precisely, I refuse to submit to the end-of-life torture by our medical system. After having a parent decline slowly with dementia due to Parkinson's -- so painful for both of us -- I've decided that I'm checking out if I start displaying signs of impending dementia. Have a family reunion, say my goodbyes, and then adios.

May. 31 2013 11:13 AM
RJ from prospect hts

If the issue of class is not included in every part of the discussion, most of it will be irrelevant. If the "contributions" of the extraordinarily wealthy are not factored in, having a debate of late-life health care vs. day care, is deficient. The "torture" issue is also moot because the costs of health care are distorted by wealth: the "boutique" care in the penthouse of the NY Columbia Presbyterian Milstein building vs. the average elderly facing poverty with the diminishing levels of Medicare and Medicaid (which pays for long-term care).

May. 31 2013 11:12 AM
Ed from Larchmont

The Catholic moral tradition teaches us the distinction between treatment and care. If someone is too elderly or sick to significantly benefit from treatment, it can be refused, as extraordinary. But care - food, water, shelter - can never be refused or denied a person (unless in the case of food and water the person is actively dying and the food or water would hurt them).

But we will see 'death panels' and rationing with Obamacoverage, of course.

May. 31 2013 05:44 AM

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