Human Exceptionalism

How to Avoid Death Panels

With all the controversy about paying doctors to hold end of life conversations arising again, I thought I would weigh in on how people can best avoid being subjected to death panel scrutiny.

The answer? Talk about it with physician, family, and friends. And write an advance directive! From, “How to Avoid Death Panels:”

The best defense against having your life’s worth judged by a death panel isn’t hiding in a hole of denial but having “the conversation”—or better stated, conversations—about what you would and would not want at the end of your life, should you become incapable of making your own medical choices. 

These are not simple discussions. There is a lot to consider and a lot at stake. Do you want CPR if you have a cardiac arrest? What about antibiotics if, say, you catch pneumonia? Then there are potential questions of feeding tubes or kidney dialysis.

But you say: How do I know whether I would want or refuse these things until I know what my overall condition will be when these issues arise?

That is why a one-off “conversation” isn’t enough. Rather, you and your doctor, family, and trusted friends should engage in a continuing dialogue.

Not only that—talk alone isn’t enough. Your best chance of avoiding sentencing by death panel is to put your medical preferences in writing in an advance directive, most particularly one that names a trusted loved one or friend to be your legally appointed surrogate to make these choices if you become incompetent.

I tell two true stories–one about my late uncle–demonstrating how talking and writing about what was and was not wanted ensured that Alzheimer’s patients’ wishes were honored.

Following my prescription won’t guarantee that a death panel might not one day turn thumbs down on your continued care. But it sure will make it harded to push you out of the life boat if you made it very clear you don’t want to be pushed. 

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