Elizabeth Clift’s poignant narrative about her experience with hospice during the illness of her husband is must reading. She notes the underutilization of Hospice care and observes:
The problem is more attributable to the widespread ignorance and denial about the cascade of events that occur when death is imminent. “The well-documented failure in counseling patients about their prognosis and the full range of care options, including early palliative care, leads many patients to acquiesce to more aggressive care without fully understanding its impact on the length and quality of life,” says physician David C. Goodman, the lead author and co–principal investigator for the Dartmouth Atlas study and director of the Center for Health Policy Research at the Dartmouth Institute for Health Policy and Clinical Practice.
In 2009, when a provision was inserted in proposed national health reform legislation that would have allowed Medicare to pay physicians and certain other health care providers to discuss end-of-life choices with beneficiaries, former Republican vice-presidential contender Sarah Palin characterized the proposal as leading to “death panels.” The phrase took hold, putting Democrats and President Barack Obama on the defensive, even though it was a Republican, Sen. Johnny Isakson of Georgia, who’d introduced the provision. “How someone could take an end-of-life directive or a living will as that is nuts,” he told the Washington Post. “You’re putting the authority in the individual rather than the government. I don’t know how that got so mixed up.”
Medicynical note: in many ways we are a culture in denial