What the End-of-Life Conversation Can Bring

Ed and Catherine Pratt are fierce rivals. Their battlefield is a cribbage board, and competition is in full swing this summer, though Ed is nearing the end of his life. The couple faces off in Ed’s bedroom, on the ground floor of their North Plymouth home, where the Pratts’ daughter and her family live in a second-floor apartment. Most evenings Ed and Catherine listen to the pitter-patter of their 3-year-old granddaughter, Caleigh, running across her living room and down the stairs before she bursts in to ask for chocolate milk.

“I asked the doctor if he could give me a ballpark number,’’ Catherine recalls. “He looked at me and said, ‘Four months. Six if you’re lucky. Let’s get Ed comfortable.’ ’’

With those words Vera initiated what many doctors, patients, and families never get around to having: a conversation about the end of life. The very idea of it is so loaded that a provision of the Obama administration’s health care overhaul to reimburse physicians for advance-care planning consultations with Medicare beneficiaries ignited a furor, with critics predicting the formation of “death panels’’ and the rise of government-backed euthanasia.

“Everybody is afraid of death; it’s part of being a human being. But this regressive thing happens when there’s a big public conversation,’’ said Don Schumacher, president of the National Hospice and Palliative Care Organization. “This legislation is an opportunity to begin. Between 2011 and 2028, 70 million people are going to die. That’s a lot of people to care for, and we need to have these conversations.’’

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What the End-of-Life Conversation Can Bring