Recent articles discussing end-of-life issues are timely in light of the effort being made by President Barack Obama to decrease spending. The last few days of life constitute 27 percent of our health care dollars, but is spent by only 1 percent of the population. The push for more living wills is laudable, but the language should be made to make it impossible to challenge in court.
However, the reality is that when these patients appear in our emergency rooms or intensive care units, those living wills can never be found. They are often part of the medical record in a hospital or at their doctor’s office. And these are never open on a weekend, when decisions often have to be made.
When I was CEO of the Hawaii Medical Center, it was a huge fiscal problem, but we did not have any solutions. Ethicists and legislators have discussed this topic ad nauseum. We sometimes had patients that would stay on life support for months because no one was brave enough to pull the plug. One patient lingered for a year. At the start, families came in droves but slowly dwindled to a few or even zero as the months went by. It’s just human nature. There is no longer dignity in the dying when you are attached to all kinds of machinery to keep you alive.
So, in this mobile society, we need a simpler system to help the medical team find that document. It will save the family the anguish of having to make that decision. Isn’t it enough that they’re grieving for a loved one who is dying and now they’re being asked to terminate life support?
Forty-one percent of the U.S. population had living wills in 2007. All we need to do is to make their wishes easily retrievable: It should be on their person, perhaps a notation on their driver’s license, an implanted computer chip or a database that can easily be downloaded from a cloud. I am sure iPhone will come up with an app for that. The faster we find a solution, the faster we can help reduce 27 percent of our health care costs.
However, making this happen may be a slow and tedious process. That’s because it will require legislation. Discussions may revert back to the emotional topic of stopping life support. We have to stay away from that and just focus on those folks who have already made it clear by having a living will. So, talk to your legislators — the faster we make it happen, the faster we help save those health care dollars.