Earlier this week the French parliament acted in a compassionate – and certainly controversial – fashion by passing a law that will allow terminally ill patients to opt for “deep sleep” as an alternative to and/or palliative care. Lawmakers there believe (and by a substantial majority) the measure does not legalize euthanasia, but not everyone agrees. And the applicability of such a policy decision to America’s struggle with healthcare cost containment could not be more profound.
Depending on which study you want to believe, it is estimated that between 25% and 30% of all Medicare spending each year goes toward the 5% of beneficiaries who die in that year. Of that, approximately one-third of expenditures occur in the last month of life. If it weren’t for the realty that life is the most precious commodity on earth, it would be a rather simple fete accompli that such investment is ludicrous.
But any discussion of healthcare policies touching upon end-of-life care is rife with raw emotion and often political hysterics. Death Panels anyone? While Sarah Palin may have done more personally than anyone in history to obfuscate rational, intelligent discussion on reconciling individual rights with social responsibilities she nonetheless hit the mark in connecting the end-of-life care conversation to rationing: because that’s a core element of the policy debate – and it needs to be.
The talking points surrounding healthcare policy that affects end-of-life care are, however, spreading beyond just rationing – as the actions in France indicate. There is a shifting cultural perception of death as not so much a medical problem as it is a spiritual reality that can only be effectively addressed by one person – one moment at a time. And the quality of life vs expenditure is an emerging debate that will be owned by the Baby Boomer generation in a way this country has never seen.
Do the actions of the French lawmakers reflect a cultural awareness that is progressively ahead of where we stand in the US? Or do they reflect the further advance of progressive abandonment of respect for the sanctity of life that we must stand fast to defend?
Before answering, consider . . .
To be, or not to be, that is the question—
Whether ’tis Nobler in the mind to suffer
The Slings and Arrows of outrageous Fortune,
Or to take Arms against a Sea of troubles,
And by opposing, end them? To die, to sleep—
No more; and by a sleep, to say we end
The Heart-ache, and the thousand Natural shocks
That Flesh is heir to? ‘Tis a consummation
Devoutly to be wished. To die, to sleep,
To sleep, perchance to Dream; Aye, there’s the rub,
For in that sleep of death, what dreams may come,
When we have shuffled off this mortal coil,
Must give us pause.
~ Hamlet, Act III, Scene i