Making End-of-Life Choices

Re “A Gift for the Living,” editorial, June 3: There is a simple approach to the problem of when to pull the plug on the terminally ill, and that is to require all medical insurance policies, including Medicare, to offer alternatives related to terminal illness. Persons covered would be required to select options of treatment. These options, clearly defined, should vary from all-out actions to prolong life to only those necessary to relieve pain after a patient is determined to be terminally ill. The cost of the policy would vary depending on the option selected.

Of course, there would have to be very strong precautions to ensure that those who determined the status of the terminally ill were not beholden in any way to the insurer.

People, as you state, have a hard time dealing with death. This approach would require them to deal with this health care decision at a time when it is most appropriate to do so.

Richard Foy

Redondo Beach

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Re “Court Hears Bid to Let Man Die,” May 31: I must give my support to Robert Wendland’s mother in her fight to not allow the removal of his feeding tube. As a registered nurse who has worked for more than 10 years in nursing homes, I have dealt with many patients and family members in similar situations. Although I empathize with his wife, and many may question the quality of his life, Wendland did not make his wishes known legally, in writing, prior to his life-altering injury. If we honor every request to pull the tubes on patients who are conscious but unable to express their needs or wishes (and not in a persistent vegetative state), it is equal to euthanasia. If Wendland’s mother and wife were in agreement, that would be different. But who can blame his mother for wanting to allow her son to live, albeit with these injuries?

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Lauri M. Berney RN

Laguna Niguel

While I thank you for your fine editorial pointing out the importance of advance medical directives, I must protest your description of the medical condition of Wendland. Your editorial stated that Wendland “appears conscious.” No, he is conscious. That is the one undisputed fact in the entire six-year ordeal between his mother, who wants his feeding tube maintained, and his wife, who hopes to have it removed so that he will die.

At the trial, it was demonstrated that Wendland could maneuver a wheelchair down a hospital corridor, write the letter “R” of his first name, take a peg out of a Pegboard and return it when asked. He even sometimes answered yes or no questions accurately by pointing at a board, for example: “Is your name Robert?” Yes; “Is your name Michael?” No. When he was asked, “Do you want to die?” he did not answer either way. One of the Supreme Court justices stated that in her opinion, this refusal to answer expressed ambivalence.

Wendland is a conscious, cognitively disabled man and should have been described as such.

Wesley J. Smith

Oakland

The writer, author of “Culture of Death: The Assault on Medical Ethics in America,” has filed a court brief in favor of Wendland’s mother.