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More should be done to improve "end-of-life" options

Nov 18, 2015

There was a report on Michigan Radio’s Stateside program two days ago that revealed that while nine out of 10 of us want to have an end-of-life conversation with their doctors, only about one-sixth of us have actually done so.

That didn’t surprise me.

We all know intellectually we are going to die, but mostly in the same way we know the sun will eventually burn out. Or as the comedian W.C. Fields once said, “I know everybody has got to die, but I thought somehow an exception would be made for me.”

"I know everybody has got to die, but I thought somehow an exception would be made for me."

Well, it wasn’t for him and it won’t be for us – and as the first baby boomers hit 70, more and more of us are realizing that.

Starting on New Year’s Day, the federal Centers for Medicare and Medicaid Services will start reimbursing physicians for having end-of-life conversations with patients and their family members.

My hope is that these conversations will lead to more of us carrying organ donor cards.

I do think many of us in Michigan are acutely familiar with these issues than most, thanks to an internationally famous figure.

Twenty-five years ago this summer, a little-known unemployed pathologist connected a woman in the early stages of Alzheimer’s disease to a crude machine he’d made. “Have a nice trip,” he told her as she pressed a lever.

Moments later, she was dead.

The doctor’s name was, of course, Jack Kevorkian, and for the next nine years he waged a fiery crusade to convince the world that physician-assisted suicide was moral, humane, ethical and made sense.

Kevorkian’s own idiosyncrasies and bizarre personality has been the stuff of books and movies. He became an international sensation, and did get the nation talking about end of life issues. In the end, his own ego and bizarre emotional needs caused him to self-destruct.

Desperate for more attention, Kevorkian moved on from assisting suicides to actually performing euthanasia, fired his longtime lawyer, the brilliant and often obnoxiously flamboyant Geoffrey Fieger, and Kevorkian managed to get himself convicted of second-degree murder.

He served eight years, got out after he pledged to end his crusade, and died four years ago in relative obscurity.

Yet despite his antics, Kevorkian did have a lasting and powerful impact. More than anyone else, he made us see that medical science is now capable of keeping people technically alive long after those lives lose any quality.

In the quarter century since Kevorkian burst on the scene, four states have legalized physician-assisted death.

We learned that too few doctors even did enough to relieve their pain, and that society was in a state of denial over all of this. It was no accident that Kevorkian was acquitted by jury after jury. Too many older jurors had seen someone suffering in agony, begging to be allowed to die. Prosecutors eventually stopped charging him.

In the quarter century since Kevorkian burst on the scene, four states have legalized physician-assisted death. More are sure to follow. The hospice movement has grown exponentially, and now helps ease the end of life for a million and a half people a year.

Yet, we still haven’t completely solved the problem of what choice we give people who are not terminally ill, but whose lives are no longer worth living.

As we all age, you can bet this is one issue that is not going away.

Jack Lessenberry is Michigan Radio's political analyst. Views expressed in his essays are his own and do not necessarily reflect those of Michigan Radio, its management or the station licensee, The University of Michigan.