Death & Taxes

The old saying is true: There are two things you can be sure of in life – death and taxes!

Every April there is a great deal of grumbling going on over the excessive amount of taxes we pay to an ever ravenous government. Most of us dismiss this as part of the price you pay to live in the greatest country in the world.

But what about death?

Now I grant you this is not a topic folks like to discuss, but it is an important one nonetheless. I have chosen to address this topic because of a recent situation that once again highlights the importance of family members conveying their wishes when it comes to their death.

For the past several years I have served on Memorial Hospital’s Bioethics Committee. Many hospitals today have something similar to a bioethics committee, or possibly a bioethicist on their staff. A bioethicist is a person trained in the ethics of medical research and treatment. This person looks at the moral implications of medical treatment as it pertains to a patient particularly when advanced technological means are to be implemented. If the hospital does not have a bioethicist, then they may opt for a group of volunteers to serve on a committee comprised of doctors, nurses, the hospital chaplain, ministers from the community, and various medical consultants. In my case, during my doctoral studies it was my privilege to take several classes in bioethics at Loma Linda University Medical Center in Southern California. Our committee is headed by a physician.

Every two months the Bioethics Committee meets to discuss various issues that the medical staff may be facing. We serve in an advisory capacity to the hospitals medical staff by looking at the issues from various perspectives, recommending alternatives and options perhaps not previously considered. I have been impressed with the level of care and concern demonstrated by the medical folks in seeing to it that all available options are examined in the total treatment of a patient. The family members of the patient also have access to the ethics committee should there be a need. Usually this comes about when there is disagreement within the family as to what medical procedures should be followed. These are difficult moments for all concerned. That being said, there is one area that is particularly difficult for the medical staff to handle.

Occasionally, there is a patient who is brought in with no record of any next of kin. The case we were faced with recently centered on a fifty-five year old homeless man who had lapsed into a coma. His prognosis was bleak. There was no reaction to any of the sensory tests performed, nor was there any brain activity. Herculean efforts were made by all to track down a family member. The nursing staff that has been taking care of this man in ICU is heartsick that he is apparently going to die without any family at his bedside. We on the Bioethics Committee had also made efforts to reach any family members of this man, to no avail.

Barring a miracle, this man is for all intents and purposes, dead. As stated already, there is no brain activity, nor is there reaction to any tests administered to help determine some sign of life short of a pulse.

Here’s where you come in. Does your family know what your wishes are when your life comes to an end? Have you made out a will? A living trust? A medical directive? Anything that expresses your desires should you find yourself in an “end of life” situation? If not, those decisions will have to be made by your family and the hospital medical staff – which means it may not be as you would have wished. You should consider the ramifications of any such decisions because if your loved ones need to make that decision in the crisis of the moment when emotions are running high, it puts everyone at a distinct disadvantage.

All hospitals have medical consultants who could provide or recommend trained personnel to walk you through the steps necessary to make sure your wishes are clearly expressed. As a pastor I have had such folks come and speak to my congregation in the past, which is helpful because it allows you to evaluate all your options without the pressure of making immediate decisions.

My step father had just turned eighty when he lapsed into a coma one morning while reading the paper in bed. The family members traveled from the four corners of the globe to be with my mother. We discussed his prognosis with the doctors. There was no longer any brain activity. As a family, we all knew what his wishes were. As hard as it was to authorize the removal of the respirator, it was far easier knowing this was what he would want.

Don’t put this off. Take time to discuss this with your loved ones and then make sure it is recorded in a document that can be referred to when needed.

It is a hard thing to do, but it is the right thing to do.