Why Can’t We Take Death Seriously? The Obama Administration’s Latest Retreat

Yes, friends, it’s back: the specter of those Death Panels just won’t go away. We all saw the troubling news story about the Obama administration withdrawing a very mild Medicare regulation, published only last November, that would have allowed for the reimbursement of physicians who discuss end-of-life choices with Medicare patients during the course of annual physical exams.

The administration played this off as a mere bureaucratic mix-up: an unidentified spokesman fed reporters some spin about how the provision for advance care planning should have been included in the original publication of new Medicare rules back in July in order to allow more public comment.

But the Boston Globe got it right in a stinging editorial: the truth is that the administration simply caved before the still potent specter of so-called “Death Panels”—a specter created last year by the likes of Sarah Palin, John Boehner, and other disingenuous opponents of health care reform. Let’s just say that in this new year, Team Obama is worried to death (pardon the expression) about defending its signature health care law from further assaults from the newly-emboldened Republicans. Calling the administration’s latest retreat “lamentable,” the Globe says that the White House “should have stuck by its convictions.”

Mind you, the regulation would not have required physicians to have these conversations with patients; it would merely have made sure that the doctor’s time is covered in the event that the subject gets raised during the course of a regular check-up. And, as the Globe commented, “Far from depriving patients of the right to make decisions about their own care, the regulation would have increased their autonomy by encouraging discussions about care options during routine exams and not in the midst of a medical crisis.” (emphasis mine)

Death Has Been Swallowed Up in Denial

Here is what needs to be said loud and clear—and religious leaders should be leading this conversation in death-phobic America:

We merely give death more power by pretending we can evade or escape it. And what’s more, it is horribly unfair to friends and family members for those of us who are growing older not to make sure that we have our affairs in order by way of clear health care directives.

I realize that religion’s cultured despisers—militant atheists and others—like to say that believers are actually the main perpetrators of delusion and denial when it comes to dying. They love throwing St. Paul’s words about resurrection into our faces: “Death has been swallowed up in victory: Where, O death, is your victory? Where, O death, is your sting?”

Do not expect me to argue that religion’s power has nothing to do with a deep-seated human anxiety about dying. But it is foolish for religion’s critics not to see just how traditional faith engages the reality of death: not by denying it, and not by counseling people to try to evade it through longevity-enhancement therapies and whatnot, but mainly by urging believers to have no fear. And also by giving people the important information that living well becomes impossible if one attempts to push death out of one’s consciousness.

Healthy religious faith is death-affirming, not death-denying, regardless of whether it’s the kind of faith that promotes belief in an afterlife or the kind of faith that is dubious or silent on the subject of survival beyond the body. Both kinds of faith encourage the awareness that “we come this way but once.” St. Paul himself would admit that facing death squarely helps to remove death’s sting: it’s not just the hoping-for-resurrection part that helps to mitigate the bitterness; it is very much the facing-the-music part.

The Great Unmentionable

It continues to astonish me that in this most ostensibly Christian of nations we also find the most obstinate refusal to face the fact of dying and the least capacity to embrace death as a good thing—as part of the goodness of living. The only explanation must be what the sociologists of religion have long reported: that the “Christians” merely tell researchers that Christianity is their creed of choice, whereas their actual functional faith is the “religion of me.”

These me-centric folks will probably never experience the mystery, or the majesty, of being alive at all. And if their preachers aren’t giving them the straight story about how death and life are intertwined—or if they somehow can’t seem to hear it when their preachers bring it up—then it would be really great if their doctors could help out a little bit.

Alas, even that little bit of help will continue to be scarce. In subservience to poisonous political chicanery, we’re just going to put a great big “Shhhh!!” in front of The Unmentionable Subject.

More’s the pity for us. The dishonesty and cowardice of not facing it—and not talking about it—will just make dying in America that much messier and more painful for all concerned.

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