Die and let die

Here's the thing, you're going to die. Your grandparents are going to die, your parents are going to die, and you are going to die, hopefully in that order. Perhaps this comes as no surprise to you, but if you were born and raised in the U.S. it is possible that you have not yet had to confront death up close and personal. Americans rarely die in the arms of loved ones or even in their own homes. It is much more likely that we will die attached to a latex octopus of tubes, bags and noisy machines. This, in my opinion, is the greatest casualty of American health care. Why can't we just die?

Most people would never wish such a painful and prolonged demise upon their loved ones if they knew what it was really like. Some people do know, sign DNR (do not resucitate) orders, and are still subjected to expensive and invasive "heroic" medicine because of fear of litigation. So what can we do to give our loved ones and our selves the "good death" that has become more myth than reality in modern society?

The experts on palliative care, the clinical term for non-curative management of symptoms at the end of life, are hospice providers. Some of the richest experiences of my music therapy career have been providing care at the end of life through hospice. Rather than the intense and often experimental treatments in mainstream medicine, hospice focuses on pain management, spiritual and emotional care, and preparation for death in a peaceful and warm environment, often the patient's home. Also, every adult needs to prepare a living will so that loved ones can honor that person's wishes without agonizing over what they would have wanted. Finally, anyone who cares about a loved one's right to die should petition their lawmakers to pass legislation similar to what is currently on the books in Oregon. Yes, this is controversial, and unfairly used to charicature the liberal tendencies of that part of the country. This is not a partisan matter however. Oregon may be the only state that admits it, but "assisted suicide" is practiced in every part of the country. Every day, physicians and nurses nationwide make clinical decisions that may aid in reducing pain while accelerating the death of patients already at the end of life, often through continued use of large doses of opiates like morphine. The use of legal methods like those in Oregon would likely lead to less risk of abuse and increased opportunity for patients to have their wishes for end of life care honored.