A lot of the commentary about Ted Kennedy’s death has focused on his involvement in health care legislation over the years, and has speculated about how his absence from the Senate might affect the current debate. But there’s another aspect of his death that is equally relevant to the debate….the manner of his dying itself.
Today’s New York Times contains reporting by Mark Leibovich that outlines how Kennedy controlled the process and the experience of dying, so that he would have a “good ending.” Yes, upon his initial diagnosis, he did take “prudently aggressive” treatments of surgery, chemo and radiation. But when it became clear in recent months that these would not halt the progress of the disease, he re-oriented himself to making the most of the days he had left, and apparently didn’t attempt heroic life-extending measures at the end.
If everyone who is in the final stages of a terminal illness did that…..just that….only that…….it would go a long way towards “bending down” the health care inflation curve. You’ve seen the statistics about what a high portion of Medicare is spent on people in the last six months of their lives. Obviously, each of us is going to be in that zone at some point. How we behave when we get there, the choices that we and our families make, will have a profound impact on our ability as a nation to pay for health care.
When my Father was dying of kidney failure at the age of 86 (ironically, in the Hyannis hospital, a few miles from the Kennedy compound ) it would have been quite possible to “save” him by putting him on near round-the-clock dialysis. But to what end? He had said all along, when he was still fully clear, that he didn’t want a life where he would spend most of his waking hours hooked up to a pain-making machine. And even in the fog of his actual dying, when dialysis was offered to him by the hospital staff, he didn’t accept. “I don’t know” was the diplomatic most they could get from him, a decline that to me reflected both his faith and his courage about taking “the big trip.”
But as medical technology invents ever more sophisticated (and more expensive!) ways of keeping people alive beyond their body’s natural abilty, I believe it will eventually come to a point where not just “Grandma”, but every single one of us, will have to ASK to have “the plug pulled”, or even turned it down in the first place. When that choice comes, let’s hope we can all follow Senator Kennedy’s example. If we don’t, there is no hope at all of controlling medical costs.
John Mihalec was a White House speech writer for President Ford, and an aide to US Senator Lowell Weicker and Illinois Governor James R. Thompson. He joined IBM in 1978, and has been a Vice President in IBM Communications since 1995.