The irony of it all. How can we, as individuals, have an adult conversation about death if we, as a nation, are incapable of having an adult conversation about death?

This sure seems like the present case, given all the inflated rhetoric and demagoguery buzzing around public discourse on health care reform. What should be a solemn, serious debate about philosophies of care for the end of life has been turned into theater of the surreal.

The prospect of government-backed “death panels” has actually gained traction, thanks partly to a bizarre remark from a former governor and vice-presidential candidate, Sarah Palin.

August, which was viewed as a period of “cooling off” for the overheated opinions about health care in Congress, has been anything but. Across the nation, discussions of health care have melted into myth-busting, rather than informed debate of the various plans.

There are many culprits, from those who propagate the misinformation to those who decide satire is more important than solid facts.

These are dangerous distractions, because the myths are just that, myths, while the real effects of the reform plans go under-reported and misunderstood. The provisions for end of life are the clearest examples, because the real concerns of older citizens and their families aren’t served by the cluttering, inane conversations about whether there’s truth behind the “death panels.”

There isn’t. And there are plenty of things to praise and pillory in health care reform without having to listen to outlandish claims of assisted suicide or euthanasia

There is truth about fears of health care rationing, and decisions about care being removed from the patients and their families and transferred into the hands of bureaucrats, bearing the calling cards of government or insurance companies. Some countries on this planet make these decisions for their citizens; in America, however, the patients’ wishes should reign supreme.

Planning can ensure these wishes are addressed, hence the inclusion of “end-of-life counseling” into drafts of the reform bills. The idea behind these provisions is to provide funding for this voluntary counseling under Medicare, to reduce barriers to having important, adult discussions about death.

End-of-life counseling isn’t an idea that will fly with everyone, but there is good sense in advocating for discussions about these matters proactively, rather than letting circumstances — instead of individual desires — determine how loved ones spend their final days.

This requires, though, an adult conversation about death. Yet the question remains: How can we weigh the merits of having one, if the nation seems unable to have one?

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