As a physician and a Medicare recipient I hold double stakes in the health care debate. And as a father and grandfather, I am interested in bequeathing to future generations the most effective and sensible health care delivery system. • I am a lifelong pro-lifer who opposes abortion in all circumstances except when the physical life of the mother is imperiled, and I oppose embryonic stem cell research. But make no mistake: I am in favor of preserving life, not of prolonging death. • So the ridiculous debate about "death panels" irked me. All the proposal asked for was that physicians be compensated for end-of-life counseling, an activity that already may claim as many as 20 hours a week of any conscientious provider.
In the best American tradition of individual freedom, this counseling allows patients affected by serious and terminal diseases to exercise their autonomy and decide for themselves when the time has come to face death.
Though painful, I consider this counseling one of the most rewarding prerogatives of my profession, a time when I have the privilege to accompany another person to the ultimate threshold of life. Even when it's clear a cancer can no longer be cured, I still have the opportunity to heal the patient.
Healing involves coming to terms with one's own mortality, accepting the fact that our earthly life is finite and perishable even if we are made for the infinite, co-opting death as part of life, in the best Judeo-Christian tradition. Remember Ecclesiastes: "There is a time to be born and a time to die."
As the unknown priestly writer of the biblical text knew very well, we are all doomed if death is the ultimate enemy. The only way to defeat death is to recognize in death a human experience like any other, to make sense of our own death.
A few years ago in a Perspective essay, I told the story of the chief of a disbanded tribe of American Indians, whom I had the privilege to treat for prostate cancer.
He wanted to write the history of his tribe. And he decided to forgo a chemotherapy that might have prolonged his life by a few months but would have left him unable to complete this important duty.
The chief taught me that what makes our life worthy is a sense of mission, of each person's unique calling. Only he could write that history. Each of us has something equally important within us, something only we can do.
A life gains meaning only when it is spent pursuing that special task. And as the chief made clear, it is worth dying for this calling.
Modern medicine now manages death.
Theoretically at least, nobody should die anymore of respiratory failure or cardiac failure or renal failure, thanks to the machines that can substitute for our failing organs, nor of starvation thanks to the ability to provide parenteral nutrition even when our digestive tract ceases functioning.
So modern medicine raises the question: When is it the time to die?
The Indian chief provided the answer: It is time when prolonging our life interferes with our life's mission, with what we have been called to do.
Then, the prolongation of life becomes really the burdensome prolongation of death.
Since ministering to the chief, I have witnessed hundreds of cases where persons came to terms with their own deaths.
Of course they were fearful of the unknown, but all of them died with the peace of mind to have accomplished what was expected from them, to have left a print on this Earth that may be forgotten, but not erased.
Believers and nonbelievers alike felt that they had contributed to the redemption of this world.
A redeemer, in ancient Israel, was the family member who prevented the enslavement of a man and his family by paying that man's debt.
The ultimate goal of life is indeed to pay for somebody else's debts, to use the nightmare of living for the creation of beautiful and lasting testimonies of our humanity, as Octavio Paz wrote in The Labyrinth of Solitude.
While claiming that they want the government out of health care, the mob that decried the so-called "death panels" calls for the government to interfere with the exercise of personal autonomy, with the most meaningful time of a patient-physician relation.
They claim to be true Christians, yet they deny the redeeming value of death, which is the door to immortality in the Christian tradition.
Dr. Lodovico Balducci is a professor of oncology and medicine at the University of South Florida College of Medicine and is director, Division of Geriatric Oncology, at the H. Lee Moffitt Cancer Center.