New Jersey is creating a new end of life commission to recommend public policy around end-of-life care. From the legislation:
3. The purpose of the advisory council shall be to conduct a thorough and comprehensive study of all issues that it deems appropriate for the consideration of its members relative to the quality and cost-effectiveness of, and access to, end-of-life care services for all persons in this State, and to develop and present policy recommendations relating thereto for the consideration of State agencies, policymakers, health care providers, and third party payers. In developing its recommendations, the advisory council shall have, as its overriding concern, to promote an end-of-life care paradigm in which patients’ wishes are paramount and they are provided with dignified and respectful treatment that seeks to alleviate their physical pain and mental anguish as much as possible.
The cynic in me—growing more prominent as I age (much like the hair now growing on my ears)—thinks this is just more bureaucratic churning to avoid actually doing anything worthwhile, or to continue the ongoing project of erecting the bureaucratic state, or both. The anti euthanasia activist in me worries that an end of life commission will really be about saving money on the sooner deaths of the dying—either via Futile Care Theory or worse—than actually improving the treatment of dying people. And I have no doubt the doctor-prescribed-death crowd will be pushing for legalizing assisted suicide.
But the optimist in me still hopes the commission will actually recommend ways to better help dying people and their families access services to help them live well until their parking meter time expires, in the understanding that dying isn’t dead—it’s living. In other words, it could go either way, or even, both at the same time.
In the end, much of it will all depend, as these exercises always do, on who is appointed to the commission—and even more importantly—on who is hired to be permanent staff.
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