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Submitted by Greg Zwahlen on Mon, 8/2/2010, 4:07pm
There was a thought provoking article in the New Yorker this past week about death, dying and hospice care.
The issue is pressing on a number of levels—apparently “twenty-five per cent of all Medicare spending is for the five per cent of patients who are in their final year of life, and most of that money goes for care in their last couple of months which is of little apparent benefit.” That’s a big part of the reason why so many Americans can’t afford health care at all.
Those dying patients aren’t benefiting as much as they should either. Dying patients, it seems, typically opt for painful, debilitating procedures that have very slim odds of extending their lives, and far more often simply destroy the quality of what life they have left.
According to the writer, Atul Gawande, the current state of affairs is due in no small part to our collective and individual refusal to acknowledge the reality of death. As he writes, “the simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And, in a war that you cannot win, you don’t want a general who fights to the point of total annihilation,” you want someone who understands that “the damage is greatest if all you do is fight to the bitter end.”
Part of the process he recommends involves reflection beforehand about ones priorities for the dying process. Most people who do this recognize that they value the quality of what life they have left, and don’t want to seek to extend it at any cost. But whatever one may decide, it seems that the simple fact of having done this in advance eases the dying process considerably, for both the dying person and his or her family.
In some ways, this sort of reflection mirrors the one called the “four reminders” or “the four thoughts that turn the mind toward dharma” in the Tibetan Buddhist tradition. When we live our lives in acknowledgement rather than denial of their brevity, we can set our priorities accordingly.
For those of you with experience with this particular meditation, do you find it helpful?
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