The 60 Minutes segment on end of life expenses did more than highlight inappropriate medical costs. It spoke to the role of medical technology in our cultural denial of death. As medical technology becomes more sophisticated in forestalling our inevitable end, we mistake “prolonging life” for “immortality.” Instead of treating death as a necessary price for living, we hide it as we do an embarrassing blemish. Rather than accepting it, we pretend it doesn’t exist.

With every new life-stretching achievement, our gratitude to the medical community increases, their wealth grows exponentially, and our denial of death becomes easier. So easy in fact, that few of us talk about how we want to die. We assume that there will always be time to think about it, express our wishes to loved ones, make arrangements, and psychologically prepare for our deaths.

Now, as economics overshadows ethics, we cling onto our fear of death by talking about death panels, medical rationing, and socialized medicine. Yes, the cost of medical care is ridiculous. Yes, insurance companies are out of control. Yes, our legislators weigh most ethical decisions by the number of votes they will gain or lose by taking a position. But these aren’t the problems that are leading us into bankruptcy.

Our current mess was generated by one unambiguous fact—for hundreds of years we have lived our lives as if our last breath could be moved forward forever. Instead of spending billions on prolonging life by weeks or months, we might want to think about how to make every moment of it matter as if it was our last. Maybe even champion end of life counseling, not only after a terminal diagnosis, but throughout our lives by people who are compassionate and have no vested interest in how we decide to live and die.

Hospice, which has given dignified deaths to millions, is now portrayed by many legislators as the economic choice the federal government will make if the new  care reform bill is passed; an economic strategy legislators such as Senator Grassly calls “pulling the plug on grandma.” Hospice not only can lead us away from the inappropriate use of medical technology, but it can bring us back to viewing death, not as the enemy, but as the greatest teacher we have for living.

copyright 2009. Stan Goldberg

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Stan Goldberg

Stan Goldberg is a Professor Emeritus of Communicative Disorders at San Francisco State University. For over 25 years he taught, provided therapy, researched, and published in the area of information processing, loss, and change. Stan has published seven books, written numerous articles and delivered over 100 lectures and workshops throughout the United States, Latin America and Asia. He is currently working on a novel and a book on loss. He also consults on issues of personal, institutional, and corporate change. He has served as an expert legal witness in high-profile court cases and is a consulting editor for Oxford University Press. Stan leads workshops for adults whose lives were suddenly and traumatically changed. He serves at the bedside hospice volunteer in San Francisco for Pathways Home Health Care and Hospice. and is a featured columnist in the Hospice Volunteers of America quarterly magazine. His published magazine articles, essays, poems, and plays have received numerous national and international writing awards. Written with humor and sensitivity, they have appeared in magazines ranging from Psychology Today to Horse and Rider. His latest book is Lessons for the Living: Stories of Forgiveness, Gratitude, and Courage at the End of Life It’s a memoir of his six years as a bedside hospice volunteer; an experience that taught him to accept his cancer and live fully, no matter how long that might be. He can be contacted at Numerous downloadable articles appear on his website

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