Families having less authority in end-of-life matters

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It was the summer before my 8th grade year. My grandfather, whom I affectionately called Papa, was in the hospital – again. He had been sick in the past, but he was resilient and always came back healthy. Because my grandfather was hospitalized in Lincoln City, Oregon that summer, it meant that I was in for weeks of bliss in the countryside in a nearby small town called Amity with my cousin Steven. My mother would come and get me from Steven's and we would make the hour-plus drive to the coast so I could have wonderful visits with my Papa. I loved hearing him tell me stories of when he was a little boy working in the woods as a logger. Every time I would see him, he would smile from ear to ear, and his intense blue eyes would twinkle as if he had the North Star in them.

Looking back at that summer, I should have known what was happening: Papa was dying. He had rheumatoid arthritis caused by thirty years of working as a logger in the dense Pacific Northwest forests. Everyday he would wake up hours before the sun was over the horizon, get his gear together, begin his trek up densely vegetated mountainsides with over fifty pounds of equipment thrown over his shoulders and in his tight grasp, and begin his ten hour work day. This hard work took a toll on his body. He was diagnosed with what he called “his Arthur” when he was in his early fifties, and was prescribed the steroid prednisone to control the inflammation. The steroid weakened his immune system over the years and he became very sick. I always said he passed away from colon cancer because it was easier then explaining what actually happened. In reality, because of his weakened immune system, he developed tiny holes in his colon walls that allowed bile to leak into his stomach cavity. This caused massive abscesses the size of cantaloupes to form in his abdomen and he used a colostomy for the last two years of his life. During this time he was strong and healthy because everything by-passed his colon, but when the day came to remove the colostomy, a painful series of events began rolling down hill. During that last summer, he went through three major surgeries within a month's time.

I remember my mom telling me to “say good bye” on my last visit, I now know what she meant. I gave my Papa a gentle hug, a kiss on his razor sharp beard, and said good bye. He responded, “I love you Caleb.” With that I left, and he went into his final surgery. A few days later when I was told Papa was coming home I was excited. When I arrived at Papa and Grandie's two story house at the end of public access on a logging road, I walked up the front steps and opened the door expecting to see Papa sitting in his chair in the living room as always with his paper in one hand and his electric shaver in the other (the man shaved three times a day, and his beard was like steel wool!). I don't have to tell you my shock when I saw him lying on a hospital bed hooked up to the same IV and the same machines he had had in the hospital. They sent him home to die. Papa didn't have cancer; he was not a terminal patient, and he did not have an incurable disease. Hospice and the HMO said that he needed to die in peace, but there was no reason he needed to die if he would have received the proper care. His doctor said his hands were tied there was nothing more he could do. The HMO and hospital had played the trump card and there was no way they would continue his care. He was sent home with enough drugs to sedate a small elephant and a hospital bed so he could enjoy the panoramic view of the mountains and river that were his life long home. He lived for about two weeks; some days were better then others. Then one day mom called and said he was gone.

As we face end of life legislation today, we are presented with phrases like “quality of life” and “rationing of health care.” What does this mean? It means that someone further up the chain of command wants the right to decide that the cost to keep a certain individual alive is greater then what they are willing to spend, and they would rather ration their care for those who need it more. I recall a line from one of my favorite movies, Fight Club, where Edward Norton's character says “on a long enough time line, the survival rate for everyone drops to zero.” It's true everyone dies eventually, but isn't it morally reprehensible that the individuals in question, and the families of, have no say in whether or not they receive the necessary life sustaining treatment? If legislation on end of life is passed, more people will find themselves on my end of the argument. Ask yourselves this, are we to let the bureaucrats in government determine whether we live or die? I challenge you to become educated on this situation so that 'we the people' can have the same dignity at the end of life that we had at the beginning of it.

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