Dr. Arthur Caplan Explores End-of-Life Issues at Annual Meeting

Why is it so difficult for an incapacitated person to be allowed to die in this country?

This thought-provoking question was explored at JSPAN’s Annual Meeting on June 24 by Dr. Arthur L. Caplan, Director of the Center for Bioethics at the University of Pennsylvania. Dr. Caplan, who has been examining end-of-life care issues throughout his career, spoke about the history of the multi-faceted struggle which has seized the attention of the nation for fifty years.

We continue to hang on the stories of these patients--some comatose from drugs and alcohol (Karen Ann Quinlan), some from an automobile accident (Nancy Crusan) and still others from a heart attack (Terri Schiavo.) Dr. Caplan discussed other cases, with different patients, but they all had one issue in common: because they did not have health directives, their fate was in the hands of those around them—whether their families, their doctors, or political or religious leaders.

Today, with an aging population—not to mention the new health reform plan--there is even more tumult over the matter of death and dying. The issue of competency is foremost: you can manage your end of life issues if you are capable, and have the skill to plan property as well as medical issues. This is why everyone should have in place—while we are still able to do so—an “end-of-life-paper” which clearly states your wishes. (Dr. Caplan says that this should ideally be done with your family around you, so that everyone knows your specific ideas on the sub ject.) There are four states in the nation, and Pennsylvania is one of them, which insist on such a directive before a patient can be allowed to die.

In Dr. Caplan’s view, life should not be a burden. An ideal health directive will set in place the benefit-to-burden ratio, which will allow for quality of life as long as a person is competent.