While, as we have pointed out, hospital costs can often be fantastically excessive (recently a man wrote of being billed $118 for two Tylenol during a hospital stay, plus more than a $1,000 for "use" of the hospital pharmacy), and while pharmaceuticals in general are completely over the top (often ten or more times expensive than abroad, in nations that have higher average longevity; this is a true urgency), and while, yes, doctors, specialists, and surgeons often levy surprisingly hefty charges (all professions, these days, are in danger of turning into businesses), there is always another side, and one of the other sides, when it comes to hospitals, are hidden costs. Furthermore, many of these are "end-of-life" issues. 

Here we edge toward truly delicate ground.

In the wake of an article we had on health costs, we received some strong mail, including from a devout Catholic nurse named Mary Powell, who wrote:

"I read your posts daily and the one on health care was interesting but missing several reasons for the rise in health care. Did you know that Americans consume eighty percent of the world's production of painkillers despite being only four percent of the world's population [see article]? My experience as a hospitalist has shed light on the above and the unwillingness of Americans to face death.

"More money is spent in the last six months of life than at any other time. The scenario goes like this: 'Your mom or dad is actively dying and it would be best to give comfort care.' The family: 'No, we want everything done.' 'Everything?' 'Yes, including putting the dying person on a ventilator, drips to keep the heart going,' etcetera etcetera. No one wants to believe that they are going to die, and the anger comes out, at us, as we try to get families to face the reality that a parent who may be in the high eighties or early nineties have failing heart, kidneys, and so forth. So we put people through terrible procedures because they can't face death. When the provider approaches the family about hospice, then the threats of lawsuits come. This occurs more often than not and when you come across a realistic family, you're shocked because you expected the threats of lawsuits.

"In addition, hospitals are going bankrupt from providing indigent care. It is not uncommon for many undocumented persons to go to the emergency room for a cold and to be seen as many as a hundred times a year in the ER  and admitted thirty-plus times. The biggest culprit driving hospitals under is the substance abuse. Often I drug-screen when things don't seem right, and, low and behold that 40-year-old with chest pain is because of methamphetamine and cocaine.

"It isn't just the young, either.

"Research the closing of hospitals. Many in the state of Georgia are closing their doors because of the undocumented immigrants that the federal government mandates must be seen and treated but are cutting Medicare costs.

"This country is in a moral crisis and decline and this is one indication of it. How often I have heard, 'it is my right to health care.' In the meantime the person isn't working and is collecting welfare but come in and use the hospital as a legalized narcotic dispensary. When you approach the patient and tell them Dilaudid is not needed for their pain, they sign themselves out AMA. I could go on and on. People need to be realistic, get off the couch, and take responsibility for their health.

"I think by now you get my point."

We do, indeed. It brings matters into sharp focus.

At the same time, much prayer must be put into end-of-life decisions. We do fear death too much. Still, we're called to preserve it as long as the Holy Spirit indicates meaningfulness: that it is not the time. Who but the Holy Spirit knows that?

A great danger: the issue of subtle, quiet, under-the-radar euthanasia (perhaps in the guise of palliative care).

This seems to be on the rise.

It is an urgent concern.

In Canada and Australia, they race toward this, along with nations such as Belgium.  Notes National Review: "Belgian doctors have expanded the kill-and-harvest agenda, even promoting it at medical symposia. For example, one group of advocates created a PowerPoint presentation, arguing that unlike, say, cancer patients, euthanizing people with serious neuromuscular diseases who want to die and donate should be accepted because such patients have 'high quality' organs. Non-voluntary euthanasia is common in the Netherlands. So too now in Belgium, but at an even higher rate. For example, a study conducted by the Canadian Medical Association found that about half of the nearly 500 euthanasia deaths the authors investigated were non-voluntary. Some of the patients were even killed by nurses. Both killing without request and euthanasia by nurse violate Belgian law, but as in the Netherlands, the law is rarely enforced."

Life is precious -- from conception to oldest age -- and we're concerned with certain statistics. In one confidential survey of two hundred cancer doctors in the state of Washington, 29 of the 81 who responded  would be willing to prescribe a lethal drug, 21 would be willing to be a consulting doctor in euthanasia, and 31 were unwilling (or undecided).

A sobering wind.

Researchers are now developing tests to see if older patients will live ten years. This can then be used as a guidepost (to see if extraordinary care is worthwhile). There is actually a "bioethicist" who goes so far as to suggest that euthanasia can be effected in those with an "irreversible condition, with no hope of meaningful recovery," by removing their organs for a transplant -- thus accomplishing two things with one stone.

A chill wind.

We'll be reporting soon on the concern that many organ donors are still alive at the time of extraction.

So we see the issues!

There is far more "mercy killing" than we imagine.

Fear not death, no. Do not be excessive. Let God work through doctors. Don't extend things artificially in a way that removes dignity from all involved. Fear not death.

But neither -- never -- hasten it.

[resources: healing books and Fear of Fire]

[see also: The 2.7 trillion bill]

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