Death Panels and Original Sin


As the debate about the reform of Health Care has increased, there has been an escalation in concern about the cost of the end of life care.  Estimates of the proportion of Medicare funds expended on patients in the last few months or even weeks before their deaths range anywhere from 40% to 60% of the total money being spent. This may seem wildly out of proportion, until we stop and realize that Medicare applies only to the elderly and that death, for this group, is one of those things that happen sooner rather than later.  But even one source close to the health care industry admits that at least 37% of all hospital costs--not just Medicare and Medicaid funds--are spent on the last three months of life. So we must ask if much of the money being spent is being wasted in futile efforts to postpone the inevitable, money better spent in keeping younger patients healthier and simply trying to make the dying more comfortable during their last days and hours.

        While it might seem farfetched, I would suggest that what this debate needs, instead of wild rumors about government “death panels” is a little more rational thought.  Of course, as humans, we all naturally fear death.  This fear is based on our animal instincts compounded by our own self-awareness. In fact, so ingrained is our tendency to avoid death, that according to the father of modern psychiatry, Sigmund Freud, it is impossible for us to imagine what it is like to really be dead.  The closest we can come to, it seems, is to imagine ourselves as spectators at our own funeral--almost as if we were still alive!  In other words, knowing that death is inevitable really doesn’t help all that much. 

        Even more, on top of this psychological problem, I think we have a theological one as well.  A naïve reading of the Bible, the Book of Genesis in particular, has led us into a frame of mind that death, rather simply than being a part of life, is in itself evil, being somehow a punishment for sin, and that if Adam and Eve had not eaten the forbidden fruit, or that if we behave ourselves and eat the right foods, we could live forever. This view, especially in the light of modern science, is unreal, to say the least. 

        However, suppose that we, like some of the Eastern Orthodox Christian theologians, simply invert the equation, seeing our fear of death as the “original sin” from which results most, perhaps even all, of our self-defeating, stupid, and often outright sinful, behavior. In fact, even without the help of this theological tradition, Ernest Becker, an unbeliever, won a Pulitzer Prize back in 1974 for his book, The Denial of Death, which explored this same obvious, even if unwelcome, truth.   Seen this way, a lot of our irrational policies--like our senseless attempts to avoid or postpone death whatever the cost--themselves begin to make some, even if crazy, sense.

        So then, what is the answer? For the unbeliever, I suppose it is to stoically “bite the bullet” and accept the inevitable, no matter how distasteful that may be.  But for the Christian, if he or she really believes that Jesus overcame death, then death, no matter how unwelcome, is but the threshold to a better, deathless, life.

        Rather than alarm over any suggestion that counseling should be provided to help the dying decide how and when “enough is enough” in our efforts to postpone death, I would, as a clergyman, consider it a dereliction of duty not to try to help people face the inevitable. Furthermore, any health care reform that refused to allow such counseling to take place would be not just irresponsible and wasteful of taxpayer’s money, but contemptuous of the meaning and value of life itself.


        R W Kropf   11/26/09                          Death Panels & Original Sin.doc  09-11-26.html