By Don Skinner

Winston Churchill is quoted as saying that democracy is the worst form of government except for every other form that’s been tried. If we ever needed proof of that pudding, we need look no further than the current health care debate. We’ve been scrapping over the issue for generations; and it’s not clear that we’re any closer to consensus now than we were a half-century ago.

Particularly disappointing has been the fabrication of false issues, one of the worst being that Congress will create “death panels” — bureaucratic committees to decide who will be given, and who denied, end-of-life medical care. Thumbs up, you get treatment. Thumbs down, you’re history. It’s one of the fattest distortions ever to debase American political debate.

Ironically, it grew out of a modest, humane and rational proposal of the kind we associate with middle America, put forward by Gunderson Lutheran Hospital (note the religious affiliation) in the unpretentious community of LaCrosse, Wisc. LaCrosse frequently appears on lists of “the best 10 places to live in America.” Now it may fairly claim to be one of the best places to die. And Gunderson is behind it.

For years, the hospital worked to ensure that the care given patients in their final days of life follows the wishes of the patients themselves. No one is, or ever has been, debating “when to pull the plug on Grandma,” as Charles Grassley, R-Iowa, so indelicately phrased it. That may go down as the most unhelpful comment ever uttered by one of the Senate’s more-respected conservatives.

Gunderson’s representatives simply asked Congress to reimburse physicians for time spent counseling patients on end-of-life care options. Armed with such knowledge, patients could then decide what they want done to, for and with them in life’s final days. The result is a legally-binding document called an “Advanced Directive” (A/D). Simply stated, an A/D spells out what care is to be given or withheld. But it goes into effect when — and only when — the patient is no longer capable of making such decisions.

Note to those taken in by the rhetoric of Alaskan ex-governor Sarah Palin: there is nothing about Advanced Directives that remotely resembles “death panels,” much less euthanasia. No one gets to decide when someone else ought to die. That decision was already made by the patient when still mentally able to reason the thing through.

This is not a trivial point. Modern medical technology does incredible things. But absent a moral compass, such technology turns tyrannical. Let me illustrate.

From 1987 to 1993 I served on Meadville Medical Center’s Biomedical Ethics Committee. My inclusion was at best disconcerting: I was the only member who lacked professional standing with the hospital. We didn’t meet often, and had no penetrating dialogues about the thorny issues of biomedical ethics. Our meetings, almost entirely pragmatic, usually centered on a near-death patient who had left no clear instructions and had become the subject of disagreement. Our task was to decide.

The ironic thing was how often we confronted a distraught family that wanted a loved one released, opposed by a physician who refused to stop treatment even absent hope of “recovery.” Had those patients had Advanced Directives, there would have been no issue. Because an A/D not only ensures that the patient’s wishes will be followed, it benefits all concerned. Medical personnel are freed from having to guess or — worse — to cling to a hopeless care plan for fear of being sued for “pulling the plug.” Loved ones are freed from having to make decisions almost too painful to contemplate or — worse — from engaging in a family row over what to do while their loved-one lies there, kept “alive” only by artificial intervention.

To those prone to assert that they’re unwilling to “play God” by withholding life-support at such a time, I reply: You already did. Had things taken their natural course, God would long since have welcomed the patient into the gentle embrace of eternity. Medical intervention prevented that. Finally to honor a patient’s wishes is not playing God; it’s getting out for the way so that God’s intentions can prevail.

I know, because I’ve been there. Last April, my wife died of consequences of vascular dementia. Her death, when it came, was serenely calm, in part because — a decade ago — we signed Advanced Directives. We had no idea whether they would ever be needed, but saw no reason to tempt fate. Our A/Ds made clear that, if there was no hope of a return to a healthful life, nature was to be allowed to take its course.

I would be hard put to overstate how comforting that was when the time came, not just for me, but for everyone involved. Anyone who thinks that “recovery” is an option in such a case is living a delusion. And we all knew it — her family, her physician and Wesbury’s memory support staff. Did I want to lose her? Obviously not. Could she be saved? Medical science as yet knows no such cure. Had she released us from making painful decisions? Absolutely.

What has frustrated the staff of Gunderson Lutheran is that a good idea, tested by years of experience, benefiting everyone involved, was sacrificed on the altar of false political rhetoric. But don’t worry. Those Midwesterners are made of stern stuff. I know. I lived among them for 12 years. Gunderson isn’t about to give up. The merits of their proposal are evident to everyone except those searching for emotional verbiage to sway public opinion. Democracy is often slow, always messy. But sound ideas generally prevail.

P.S. to Tribune neighbors: Advanced Directives are legally binding in Pennsylvania. If you don’t have any, I urge you to get some. We’re not all privileged to live long enough to die on a geriatrics wing. “Delay” can translate into “too late” with blinding speed.