By Frank Wessling
When your very old father or grandmother is suffering and probably has only a short time to live, do you allow 30, 40, 50 thousand dollars or more to be spent buying him or her a few more days of earthly existence? Do you think about the use of scarce medical resources, and that the same time and money could be spent helping a dozen children?
The second question is theoretical, of course, and imagines a universe of perfect trade-offs, but both of those questions rise up as this country thinks about a better way of treating our health needs.
President Obama tells the story of his grandmother’s final few weeks of life late last year. She was 85 years old, had been diagnosed with a terminal cancer, fell and broke her hip, and was offered the option of a hip replacement to make her more comfortable. She had the hip replacement operation and died a few weeks later.
There are other stories. This one is personal. My father died several years ago at age 90 after a fall at his home. It seemed to be pneumonia that took him after he laid a few days refusing any aggressive treatment. I believe he chose to let himself die at that time rather than allow doctors and hospitals to take over his life and spend money that, to him, represented a waste.
Regardless of the effect his fall had on his health, he wouldn’t have much longer to live — perhaps a few more years, with luck; maybe only a few months, or weeks.
He was a man of strong religious faith and, for several years, a small town banker who delighted in opportunities to help hard-working young farmers and other people with solid plans. His bank didn’t have money to throw away on vague hope or romantic wishes, but he readily invested where there was evidence of a commitment to work.
I believe he was unafraid of death although, like most of us, not looking forward to leaving this life. And I think it simply violated his sense of integrity to let money and time be spent on his frail, broken body when it could be better invested in the health and future of younger people. How could he face God after grasping for so little that cost so much.
He once told me that he didn’t feel comfortable having so much security himself — with a pension, good insurance and Medicare on top — while young people too often were hurting for the basics of a decent life. His sharing instinct was offended.
My dad was basically conservative with a strong sense of justice in the old tradition of German Catholic corporatist thought. The community owed care to all members but there was a suspicion of state involvement. Relationships were to be based on natural civic groupings like unions, business, clubs, schools, churches, farmers sharing in care for the common good. Government had a role on the edges, to ensure fairness and safety, but relationships in the community determined the quality of life.
I think Dad felt a personal stake in the overall cost of health care and wanted to be fair in what he took out of it. I’m sure he also felt a duty to leave something for his children and grandchildren, as well.
This is not to say that my father’s end-of-life choices were better than Obama’s grandmother Dunham. Each of our situations has uniquely personal elements that can’t be judged from the outside. But every personal case is also a part of common and shared costs and benefits, part of what the Catholic tradition calls the common good.
That question — the common good — must have a place at the table along with the personal feelings and individual stories as we discuss and debate the future of health care in this country.