SACO — It is with continued interest that I read articles in many papers about end-of-life issues.

In May, The Press Herald ran an article from The Washington Post about the grim outlook for Medicare. On July 10, the paper interviewed Norman Morse, who spoke out on his end-of-life desires. On Aug. 2, The New Yorker had a long, well-researched article on end-of-life choices, and on Jan. 7, the Post urged “more candor in care of dying cancer patients.”

In December 2006, the Post also carried an article on internal defibrillators that gave yet one more twist on how very tricky it is to navigate the waters of end-of-life choices.

These have all had increasing interest to me, having dealt in a very personal manner with end-of-life choices this past October. My experience during this past year causes me to want more questions as a way to find better solutions.

I think the answers to decreasing health care costs can be answered as we enable ourselves to seek better-informed end-of-life choices.

However, we need to remain open to new ways of thought and listen as much as we ask to be heard. We need to continue to have conversation and not cut it off before we seek to understand another’s point of view.

It is my opinion that we need to start the conversation about end-of-life choices when we are 21 and healthy, not when we are 81 and in the emergency room. We need to consider how to do this.

One thought is that advance directives could be part of every patient’s chart starting at the age of 21.

The directives are electronic and can easily be updated when appropriate. It would start the conversation and also give guidance as the conversation continues, if one is in a life-threatening situation.

It is my belief that through the advances of medical science we have already interfered with the natural death process. And we have done so without telling patients that there are options; that patients can say “no.”

There are times when we may want to shut off that internal defibrillator.

That yes, another round of chemotherapy may be tried on someone who is already in the last stages of cancer, but statistics show us that it will not lengthen the patient’s life span, only diminish quality of life.

Whenever we are told that we are in “end stage” of any illness, we should talk with a hospice representative and then decide what is best for us.

No one has failed because of death. It is a natural occurrence. What we have failed at is communication that is sufficient to let everyone make an informed decision.

We have falsely jumped to the conclusion that everyone will want to continue life at any cost.

For some that is true, but for many it is not, and those many have not had the information available to them to make their own choices.

Medical science has done amazing things to help us live longer and healthier lives.

What it has failed to recognize is that it has already interfered with our own natural death occurrence and has not educated either the public or physicians as to how to deal with end of life decisions.

I would like to end with a few quotations. The first is from Leonardo da Vinci: “While I thought I was learning how to live, I have been learning how to die.” And from Sigmund Freud: “The goal of all life is death.”

Last, from the humorist George Carlin: “Death is caused by swallowing small amounts of saliva over long periods of time.”

We have worshipped youth for too long. We all have forgotten that death will come.

We must educate ourselves about a subject that seems uncomfortable, and yet as the quotations point out, either with a bit of wit or sage advice, death will come.

This country was built on the freedom to choose. We desperately need to listen to one another now as we have the ability to choose how we die.


– Special to The Press Herald