Which phrase reflects your wishes?
I don’t want to die in a hospital.
I don’t want to die in pain.
I don’t want to die as a burden.
I don’t want to die.
Death isn’t a choice, but the circumstances can be. To understand options and have a say when the time comes, however, requires communication between doctor and patient, among others, while the patient can still comprehend. It requires, if you will, a "death panel."
Dr. Suzanne Koven addresses this in “A (good) death panel,” an insightful Boston Globe column about medical support at the end of life. She uses the lonely and painful death of a Tolstoy character to begin the piece, and fiction is an interesting choice, as so much of the contemporary “death panel” phobia is fabricated.
Koven notes that death is often seen as failure by doctor and patient alike, and yet it remains inevitable no matter how adept medical science gets at prolonging life. Pretending otherwise helps no one, certainly not the unreachable patient on life support or the nurse whose wrenching task it is to repeatedly change dressing on skin that no longer heals.
Koven tells a moving true story of a “good death,” in hospice, of a terminal patient after a process in which she and her spouse were engaged in conversations with an oncologist, a palliative care specialist, clergy and a psychologist. This patient was surrounded by a an extended support community at the time of death. We should all be so lucky.
To read the Koven’s column, see http://bo.st/kGrmh5
So, can there really be such a thing as a "good death" panel?