His dramatic return this week to cast the deciding vote for a crucial Medicare bill brought tears and cheers in the US Senate, even as some medical ethicists question Ted Kennedy’s decision to undergo life-prolonging (and expensive) surgery, chemotherapy and radiation.
On the New York Times Freakonomics blog, an internist involved in public health issues suggests Sen. Kennedy might have issued this statement instead:
“Because I am not a young man, the cancer in my brain will progress rapidly and is likely to incapacitate me in the near future. I trust that my doctors will do everything they can to prevent further seizures and to keep me in comfort. I will not endure extraordinary excess pain and suffering, while hundreds of thousand of dollars will not be spent on surgical debulking, radiation, and chemotherapeutic regimens which do not work.
“Modern medicine cannot cure my cancer, but it can keep me comfortable and free of pain. I have already contacted the Massachusetts General Hospital Hospice program.”
If such a suggestion seems heartless, it nonetheless reflects a crucial debate that has started about end-of-life care, which accounts for a significant percentage of Medicare expenditures.