Does end-of-life counseling help preserve dignity?

Below is an excerpt from On Faith, an Internet feature sponsored by The Washington Post and Newsweek. Each week, more than 50 figures from the world of faith engage in a conversation about an aspect of religion.

This week's question: Proposed health-care reform legislation includes a provision that allows Medicare to pay for "end-of-life" counseling for seniors and their families who request it. The provision — which Sarah Palin erroneously described as "death panels" for seniors — nearly derailed President Obama's health-care initiative. Some Republicans argue that the provision would ration health care for seniors. Does end-of-life care prolong life, or does it prolong suffering? Should it be a part of health-care reform?

"End-of-life counseling, as I understand it, just tries to ensure that everyone knows what your wishes are should you become gravely ill. Do you want to be kept alive on machines? Do you want extraordinary means used to keep you alive?

"End-of-life counseling is not some 'death panel' deciding that some people should die and others live. Rather, it is making sure that when anyone dies, he or she can do it with dignity and with the family fully informed. ...

"I hope this health-care reform bill passes soon, and I hope the end-of-life counseling is funded. Bigger than that, I hope people will take advantage of that funding should it be provided so that their end days can be as free from confusion and angst as possible."

— Susan K. Smith

senior pastor, Advent United Church of Christ, Columbus, Ohio

"No political deception this year has been more shameful than that of Sarah Palin, the Christian Right and many Republicans who have tried to sabotage health-care reform with the canard of 'death panels.' Even after many myth-debunking articles and reports, the anti-health-care reform crowd still crows about death panels. ...

"Making decisions about the end of life makes more sense when the living can discern their choices in consultation with their family doctor. That's a better course than making decisions in the midst of an emotional crisis at the end of life.

"If Medicare payments will facilitate such good decision making, then the health-care reform bill ought to include end-of-life counseling."

— Robert Parham

executive director, Baptist Center for Ethics

"Counseling the dying is a sacred responsibility. End-of-life counseling can be deeply beneficial to the dying and their loved ones. While people of faith may have connections to their own priestesses, priests, rabbis, ministers, imams or teachers as counselors, for others, faith-based counseling may not be a good fit. Mind and body are linked, and emotional support can ease the suffering of the body. Providing counseling as part of end-of-life care is good medicine, good religion and good sense."

— Starhawk

co-founder,, an activist branch of modern pagan religion

To read the complete essays and more On Faith commentary, hosted by Jon Meacham and Sally Quinn, go to

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