What Ted Kennedy’s end-of-life choices may say about health care reform.

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There’s a slim hope ventured by some in today’s articles about Senator Kennedy that perhaps his death might somehow help improve the prospects of health care reform by briefly relieving the partisan acrimony and serving as a reminder of the urgency of his signature legislative cause, which is, after all, about people’s lives and deaths. But no one is counting on it. And when you think about it, the ailing Kennedy’s own end-of-life decisions seem like every American’s ideal, hardly an advertisement for overhauling a system that makes such options possible. First, he got to choose the intensive treatment he wanted—surgery, chemo, and radiation—although his tumor was judged inoperable and lethal, and although he was diagnosed at 76. And then he got to die a dignified death, not trapped in a hospital, but saying farewell to family, friends, and dogs on Cape Cod. No one would dream of begrudging him his “good ending,” as the Times called it; it is inspiring. But perhaps the Senator wouldn’t mind if, as we pay tribute to the valiant close to an impressive career, we also note how much his “prudently aggressive” medical approach must have cost, and how unusually lucky he was in the way it played out.

Photograph of Ted Kennedy by Jim Rogash/Getty Images.

Tags: end-of-life choices, health care reform, Ted Kennedy

Ann Hulbert Slate's books editor and the author, most recently, of Raising America: Experts, Parents, and a Century of Advice About Children.

Comments

End of Life Choices

By: before_during_after | Mon, 11/16/2009 - 23:43

It's not an easy thing to do, we are all going to face it one day. Making end of life choices can be a very stressful, depressing, scary time for most, but it doesn't have to be that way. Preparing ahead of time can ease the stress and loosen the pain for the dying, family and health care providers. It can also give you choices and save your dignity!

Fore helpful tips and a beautifully made guidebook by Author Deb Waterman(Hospice, Health Care Provider)please read on. Deb has hands on experience for many years working with family and loved ones dealing with a loosing a loved one. She dedicated three plus years writing "Before (I Die), During (the Process), and After (You're Gone)". It covers advice on will making, Hospice Care, Home Safety Tips, Funeral Arrangements, Advice for care givers and MUCH more. It carries you though the Before, During and After stages.

Please visit beforeduringandafterthebook.com for more information and to view excerpts from the book.

May we all have the chance to decide what is best for us!

تحميل برامج تحميل برنامج

By: beckham_250 | Sun, 09/20/2009 - 07:55

تحميل برامج تحميل برنامج تحميل برامج نوكيا برامج
تحميل ماسنجر تحميل موبايل موقع دليل مواقع

Exception that Proves the Rule

By: kcar1 | Sat, 08/29/2009 - 19:28

Sen. Kennedy's experience could serve at the "exception that proves the rule" not as a reason not to overhaul health care in the US.

(1) As many have pointed out, he had government health care as a member of the Senate, meaning that at the end of life, his family was not plagued with the most mundane medical bills, haggling with the insurance company about what will be covered and not, etc. While the Kennedys may have never had that headache due to their stature many do and regardless of ability to pay, it is time consuming, distracting, and takes away precious time with dying loved ones.

(2) He got treatment that is the standard of treatment today. While we could argue and debate whether it was cost effective and medically necessary, Kennedy's course of treatment was not (particularly) "gold plated" (though the actual administration may have been). An acquaintance was about 6 months ahead of Sen. Kennedy in being diagnosed, treated, and dying of the same type of brain tumor and even though he was not famous, wealthy, or powerful, he received the same treatment. The same cannot be said for many who lack knowledge, support, and financial wherewithal to fight with the insurance companies, look for options, and be proactive.

(3) Sen. Kennedy expressed the desire to make it good to the end. So he and his family planned and, by all accounts, accomplished that -- the best argument for the end-of-life planning I've heard.

The Good End is an example of what is possible with the combination of (a) government health care, (b) planning, and (c) wealth/prestige not an example of how well the system works for most people, or, as Kennedy would have considered, the most vulnerable people.

What Kennedy's passing can teach us

By: lizkato | Fri, 08/28/2009 - 09:31

If anything, Sen. Kennedy's passing teaches us that government healthcare can work very well. Kennedy got appropriate state of the art care and was able to live his last days as he wished. I wonder if he had a conversation with his government executioner - I mean doctor, about what kind of care he wanted at the end? Ann Hulbert is apparently not a doctor (I am) and is unaware that surgery, chemo, and radiation are all part of standard care for incurable cancers PROVIDED THERE IS EVIDENCE THAT THEY WILL ACTUALLY PROLONG LIFE AND/OR IMPROVE THE QUALITY OF LIFE. Where comparative effectiveness research comes in (the dreaded "Death Panels") is to suggest that if there is no evidence that a new treatment prolongs life or reduces suffering, perhaps we should not subject people to it. Think autologous bone marrow transplants for metastatic breast cancer. This treatment caused huge suffering to many women (not to mention the financial cost) before proper trials demonstrated that it did not affect outcomes in any way.

I would constrast Sen. Kennedy's passing with a woman I met during training. She had had a mammogram the previous year and been told she had a suspicious mass. But she didn't have health insurance and was afraid of what the medical bills would do to her family, so she waited until the mass started breaking through her skin. It was metastatic by that time of course. She was transferred to oncology and I don't know how she died. But if she had had the same kind of government healthcare as Sen. Kennedy, perhaps she would have gotten treatment when the lump was diagnosed and still be alive.

Kennedy would want all to get quality care--not only the rich!!

By: Susi Schneider | Thu, 08/27/2009 - 22:03

Just what does Ann Hulbert think is available for most people now--even those who feel they are totally insured? Kennedy was a wealthy man who could supplement and who had the means to override any denials of care his insurance might have presented him with. If you are not wealthy in this country care is severely rationed now by private insurance companies who deny many life-saving treatments and drop clients routinely who require more extensive thus expensive care. This actually adds almost nothing to the discussion of health care that most people face in this country. Kennedy was trying to raise the standards for all. It is a myth to believe that this care is what most insured people get now and that is why we should not change things.

As an extremely wealthy

By: melanie_me | Thu, 08/27/2009 - 20:40

As an extremely wealthy person, Senator Kennedy was able to choose any type of treatment or lack of treatment he desired. This will continue to be the norm for the rich regardless of the type of health care system available in America.

wow

By: sbknowles | Thu, 08/27/2009 - 16:56

Wow, this a remarkably illogical argument. 1) he had government health care; 2) nevertheless, how do you know he didn't pay for his aggressive treatments out-of-pocket? You can shoot the moon with treatments if you can afford them and he could; and 3) overhauling the system won't mean that people will die, as you put it so eloquently, "trapped in a hospital." Yikes, what are the criteria for posting on this blog anyway?

Doesn't follow...

By: CB1 | Thu, 08/27/2009 - 16:55

I think that what Kennedy's story demonstrates, is that there is top-notch care to be had here in the US. That much is not disputed by those pushing for reform. What his story doesn't illustrate is the experience of the average citizen (even with insurance). Kennedy could afford anything he wanted. Is the fact that he had that ability evidence of a great system? Most seniors would have probably been denied his options by their insurance companies. How would his experience make reform any less necessary? Better yet, how would reform make his experience impossible?

Wow

By: katb | Thu, 08/27/2009 - 16:34

This argument is so off base I felt compelled to register to comment. An incredibly rich man got expensive treatment -- this is a reason to keep the status quo? Again, wow.

Kennedy Vs. Health Care

By: rlarrett | Thu, 08/27/2009 - 16:23

I have read this item over carefully, several times, thinking that I must have missed something. Sen. Edward Kennedy, champion of universal health care coverage, dies after a vigorous, and no doubt expensive, treatment for brain cancer. From this we are meant to understand that he is "hardly an advertisement for overhauling a system that makes such options possible." Are you saying that absent health care reform, people like me (i.e. those without insurance) can be assured of the same level of treatment Sen. Kennedy got? That because a beloved, wealthy Senator got top-notch treatment when gravely ill, I will too? That just sounds crazy. Perhaps you'd care to explain further?

What Can Ted Kennedy’s “Good Ending” Teach Us?