H.R. 3200 Section 1233 introduced by Oregon Representative Earl Blumenauer last year would reimburse physicians for holding end-of-life discussions with their patients.  I have mentioned it only briefly in this blog, and I want to communicate a few thoughts about it.

First, the conservative labeling of the bill as creating “death panels” is misleading.  I don’t see any language that sets up uninvolved bureaucrat teams to decide whether or not a person qualifies for treatment.  It is good for those of us in the watching public to differentiate political speak from reality.

Second, I don’t think the bill, if passed, would affect how physicians approach end-of-life conversations.  Some doctors like these discussions, feel they are important, and do a nice job.  Most physicians are uncomfortable with the subject and don’t want to spend 30-45 minutes talking a patient and family through realities and options.  Adding pay incentive won’t change physician activity.  Those that do it already will continue.  Those that don’t will not view earning $55 to hold these discussions as worth it.  They could easily see 3-5 other patients in the same time period and receive more.

Third, it is troublesome to me that the bill came out of the state that first legalized physician-assisted suicide.  What an awful practice.  What a debasing of human value and dignity.  What a robbing of courage.  Is this the adequate moral background to write a bill on end-of-life physician-patient discussions?

I say a big “no.”  Within these discussions are opposing influences:  the physician must balance providing the best care with the insurance companies’ financial incentives to physicians who limit treatment access to dying patients.

We are treading within dangerous land, and losing our way will bring disastrous results.  We shouldn’t follow the instructions of those who are already lost.

An article in this week’s Christianity Today spotlighted pastor John Stoltzfus who noted, “Our church doesn’t have enough funerals.”  His Mennonite community members often leave town to live with children when they become elderly and require more care.  As such, the mentioned church’s senior pastor has performed only 10 funerals in 8 years.

So why the desire for more funerals?  Attending a funeral causes us to examine our lives.  We tend to ponder what will be said about us.  And, what may be very different, “What do I want people to say about me?”

One pastor noted that funerals are a like a North Star, showing us which way to direct our lives.  It is spiritually healthy, and it can be an accelerator in spiritual maturation.  Saint Isaac the Syrian said, “Prepare your heart for your departure.  If you are wise, you will expect it every hour.”

I must say that although I agree with these sentiments, I feel it would be discouraging to perseverate about my own death.  Caring for hospice patients directs my attention on the reality of my non-permanence, and yet, my thoughts don’t stay there perpetually.

So, why does the Psalmist say, “Teach me to number my days?”  I can think of several “benefits.”  First, I appreciate what I have knowing that others have had their lives suddenly stripped from them by an unexpected illness.  Second, it reminds me that I am incapable of preventing tragedy.  As the song goes, “I will hope in the Lord my God, I will trust in the One who is worthy.”  That is rather humbling, and it is a good kind of humbling.

“Though there be no food in the fields, and the flock be separated from the fold, I will trust in the Lord.  He has made my feet like hinds feet (meaning strong), and He makes me walk on my high places.”  What do you think, reader, about these last few verses in Habakkuk?  Please check them out, and respond here by leaving a comment.  For help with the language,  use a website like blueletterbible.org.