I wish Sarah Palin would throw herself on an iceflow or at least just STFU. I'm so sick of that ignorance-loving, egotistical, self-promoting idiot that it makes me want to puke. This is what our countries politics have come to. Yuck!!!

I am currently in Chemo for stage 4 lung cancer. I started the very first discussion with my oncologist by asking if this was going to kill me. Everything you read on the internet says i will die of cancer. We are fighting it hard and have some good results but I am not disillusioned about the possiblility of death and have had the hard converstaions with my wife and family concerning what i do and do not want when the end comes. I think it is terrible that conservative poloticians, who say they are all about family values have no idea how much value there is to a family to make plans for the tough decisions instead of having to deal with it with no planning. tyl

Whenever politicians get involved in anything they turn it into a political issue. Healthcare is a political issue that is about to get a lot worse and therefore provide fodder for both sides.

Talking about end of life issues is not the same as having "death panels" making the decisions, nor is it something that should call for "special incentives" from the government since the special incentives usually are turned into requirements with the threat of punitive measures if reams of paper work are not completed.

Even this commentary has a political tilt and is divisive and inflammatory to an extent. (see comment #1).

If / when it comes time for me, I hope that my physician can and will be ready to have "end of life" discussions. While I have a living will and a health care power of attorney, it is part of the responsibility of physicians to be forthright in offering to have the appropriate discussion. I would hope that they have the ability to do so, not only with their time appropriately paid for, but that they are encouraged to provide a critical part of the general care I would expect from my physician.

I am a 2 time cancer survivor and do not know what my future brings. I have a living will, medcial durable power of attorney, my wishes on file with all Dr.'s involved including my wife and daughter. I welcomed the conversation with my oncologist. Not everyone wins the cancer battle and wehn the time comes I just want to live out my final days pain free to allw me and my family a "gentle death."

The so called "death panels" were hogwash. There were no death panels. Just converstaions that all people need to have unless they want other people to decide what your final days, weeks, and months will be like.

Who's Frank and why would I want to be him?

The discussion needs to be honest and frank with the doctors but also with the family members. Family needs to know the wishes of the individual because at one point the family will be helping to make sure that those wishes are carried out. Failing to talk about the obvious only makes the end that more difficult for the individual, family and doctors.

It is one thing when an ignorant snake oil saleswoman such as Palin sells this 'death panel' hogwash to the public, but it is really sad when someone supposedly more responsible (Senator Grassley of Iowa) jumps on that bandwagon. I wonder how many gullible people out there think that this was really in the health care bill.

my sister died from cancer last tuesday after being diagnosed just last summer. at first she was told at most she had a couple of months left but one of life's ironies was that she was a hospice nurse and knew what was out there and available, more so than most. i know but one thing for certain and that is the help that hospice provided us, the same organization she had worked for, was invaluable. from legal help, mortgage assistance, medical aid or just being there to talk as we sat at her bed side. if you or anyone you love or care for needs end of life help and we all do at one time or another, find your local hospice and just ask for help, that is all it takes. my little sister was 44 years old, our memorial is scheduled for tomorrow and some of the hardest times are yet to come. i keep referring to her in the present tense and thinking ahead to holidays and the like and then i have to remind myself, no she has passed on. for those of us left behind living with the void and getting used to it can be as difficult if not more so than the loss itself. i guess the most important thing i am trying to get across is how incredibly helpful hospice is and how we personally cannot thank them enough for everything.

Conservative politicians aren't against the kind of frank conversation you are advocating - they just want to be sure that the conversation is neither mandated by Washington nor delivered by a bureaucrat. Medical care must be between the doctor and patient without government intervention. Doctor, you undermine your important message when you politicize it.

I am writing this as I sit next to my 49yo wife's bed in a hospice ward. We have two children at home (8 & 11 yo). When an uneducated and ignorant Palin starts spouting death panel lies about an issue such as end of life discussions between a Dr, the patient and the patient's loved ones, it makes me want to break the promise I made to myself to never wish this horrific disease upon anyone.

For the record, I work for a major corporation and my health insurance is among the best. If I worked for a small business, they would have cancelled their insurance plan by now due to our costs.

Politics really have no part in any specialized field. Politicians know nothing about the nuances of different systems and should have non say in their regulations. Politicians know nothing about how a hospital works, how a school should function, public transportation needs, scientific study or anything other than beauty pageants and false claims. Politicians are just glamorized celebrities with way too much say in anything.

I find it somewhat depressing that not one of these posts concerning someone's truly courageous battle with cancer ended with a cured, healthy individual.

While difficult, these converstaions are important on so many levels.... Making sure that doctors, patients and family members are all on the same page, and that everyone understands the patients' wishes. And also that the patient UNDERSTANDS what they are asking for. My mother died from lung cancer a few years ago. About five months after her diagnosis, we were at a crisis point. Mom had expressed a wish not to be kept alive artifically (breathing machines or feeding tubes) for an extended period of time. She told the doctors she wanted a DNR order, not realizing that that meant that doctors wouldn't even try CPR, oxygen or other basic measures if her heart or breathing stopped. After two days, when she didn't die (and had some level of consciousness) one of the nurses suggested that we might want to reverse the DNR so she could receive active treatment again. Mom was angry after, because she hadn't understood fully what DNR meant, and wanted to receive active care until it was no longer an option. Had she been allowed to lie there and die, we would have missed the 21 additional months of her life that allowed her to see her first grandchild born and hold him in her lap on his first birthday.

The only problem intelligent people had with this part of Obamacare was the government incentive to doctors!

A good physician would have discussed ALL the options as part of normal care.

If "politcizing" a message means that someone pointed out the Republican Party lied about the so-called death panels, then I guess I'm guilty of politicizing things as well.

The death panels were pure fiction, a canard ginned up in order to frighten people, just as many other things are that the Republicans and Tea Party nuts keep repeating to the public.

Not so fast.

Ask your doctors about circulating vitamin D levels and the link to cancer survival.

Better still just know that 50-80 ng/ml a day (and for life) keeps the oncologist away.

I have read all of the responses to the original article. The bottom line is that most responders revealed their political leaning in the manner in which they sounded off.

While at the same time expressing that politics should not play a part in medical decisions the response was written with a political bent.

Twenty-eight years ago my wife was the victim of a medical malpractice when her doctor filed he xray without looking at it. She had late stage cancer in her right lung. She had coughing spells so hard she broke ribs. The doctor finally looked at her xray and referred her to a specialist who properly diagnosed her condition. A few day later her right lung was removed and she had a successful recovery. She had no chemo and radiation.

Fast forward 28 years. September 2009. After five months of loosing weight her doctor ordered and xray. Some shadow in picture didn't look right. Then a CT scan revealed more detail. My wife decided it was time to see an oncologist who ordered a biopsy. Result, revealed small cell, stage two tumor to large for radiation. She has been on chemotherapy with several different types of drugs since September 2009. The tumor has shrunk three different PET scans have revealed but still to large for radiation. Just this past week her Oncologist offered three choices, start taking a 1. Tarceva pill daily, costing $5,026 per month for the rest of her life (however long that is) 2. Continue taking some form of chemotherapy, 3. do nothing. The doctor's first choice is to try the pills even though they have some serious side affects.

We are still struggling with which option to take. Finances will not play a part in our final decision. I have been praying daily for a miracle from God because that is what it will take. But if He has other plans we will accept that.

All of our end of life decisions were taken care of years ago. We have our burial plots, our grave markers have been in place for more than three years. All they need is the final date. Our cremation plans are in place and paid for. All that is necessary is phone call to pick up the remains. But the best part of it is that we know that the part of our body that really matters will have gone on the be with our Lord Jesus Christ.

We don't fear death. It will be graduation day awaiting that day when we will have a new body free from all of this life's care and pain. So look up your redemption drawith nigh.

I am a stage 4 prostate cancer survivor.  I threw out oncologists years ago and started working with people just like me and some just like you.  Oncologists talk only of treatments and not cures.  The average time with most is under 7 minutes.  They treated my cancer but tried to kill my heart, kidneys, liver, and the rest of me.  Enough of that.

That was 5 years ago.  I decided that I would listen to only people that were going through what I was going through, listened to what they tried, tried what seemed to work and never gave in.  I have a friend in  NC a stage 4 lung cancer patient who went through chemo until he found he was worse off than before he started.  Then he changed his diet, exercised as much as he could, gave up eating most meat and the 4 Ws.  He is still here and the  spots on  his lungs have shrunk.

This can happen to you too if you have faith and not doubt, have confidence and not worry, have trust and not fear, and hope and not hopelessness.  It can happen.  Keep a positive attitude.

I do agree that doctors have a purpose but they aren't trained to deal with the mental side.  Become a part of a group of people just like you as I did.  We all have had the same questions.  Its easier on you and your family.

As Yogi Berra said, "It ain't over till it's over". 

Here is to looking  forward to another Christmas with family.

I have lost two wives, and in each case we made end of live decisions ourselves. I can't speak for anyone but myself and my deceased wives. We all felt that this decision was ours and ours alone to make. It was up to us to decide when the subject should be discussed and not some snotty nosed little twerp who granted had seen many people die, but had never come close to dying themselves, and most likely had not even lost a close relative. All we wanted was a compasionate person to listen and help us with our wishes. We all would have been offended if the subject of end of death discussion was brought up before we were ready for such a conversation.

If you havn't been there don't even attempt to try to tell someone else how this should be handled.

Telling Republicans like Palin to STFU is like trying to get Niagra Falls to turn around and go back up to Canada. They have no business meddling in conversations with our doctor about our death. The health care reform bill was among the best things to come out of DC in a while and they used scare tactics to get rid of "the talk." It's a valuable tool for dying patients and their families.

My husband died of Stage 4 lung cancer in May 2009. He & I had many difficult conversations. No he didn't want to die. In fact, he felt cheated and he was angry about what was happening and scared for me and our girls. But because we had these difficult conversations both together and with his doctor, all of the people who loved him were able to honor his wishes for giving him the death that he requested. I am at peace with the fact that we sent him out of this world the way he asked. It meant everything to me to be able to do that for him. Dying before your time is horrible enough for the person going and the one staying behind so isn't it time that we stop pretending it isn't going to happen until the very end when it's too late to change how it's happening. We never stopped treatment. It is a myth that insurance companies and hospice require a patient to stop treatment in order to become a hospice patient. Most insurance companies will agree to a carve out to continue treatment. Hospice encouraged us to have hope, not in a cruel way; they just told us as long as there is breath there is life and there is hope. Hospice has programs that can help so much.

I marvel at Republicans. They advocate individual responsibility and freedom, but will deny patients the right to have the most important and necessary conversation they will ever have wth their doctor covered by Medicare. They are perfectly happy to ignore the insurance companies who do have death panels and ration care on a daily basis.

The real deal is that having the conversation would mean a vast loss of business to a variety of businesses. Hospitals, med equipment companies, and drug companies would all suffer. Many people die in hospitals hooked up to all kinds of equipment. We all iknow people who died this way, and know this is far from what they would choose. The problem is, they never had the talk with their doctor. Doctors, by Hippocratic Oath and training, are going to want to use whatever tools they have to keep you alive. This alone negates the death panel garbage. No doctor will push you to refuse treatment or to limit treatment. They will lay out the choices. This takes time-you cannot do it in a 15 minute visit.

What you do have to worry about with a public plan is Republicans like Jan Brewer deciding to let people die rather than fork out for expensive treatment. This could probably be dealt with legislatively so that people would not be denied treatment. What Republicans regularly fail to tell us when criticizing systems in other countries is that they spend a small fraction of what we spend per person, but they cover everyone, including visitors with far better results in many categories. Their systems are far more efficient. If they had the money we spend, they would leave us so far behind, we would probably never catch up.

I watched my Mom die of lung cancer.  We brought hospice in but she was only in their care a few days.  Our culture does not want to talk about death and dying.  Every family should discuss it and cancer patients need not be afraid to talk about options (am I going to go down fighting till the end or will I choose to end peacefully and with dignity at home).  Patients and doctors are afraid to bring the "D" word up and that's a shame.  We don't need to rush it but we do need to plan for it.  It's the responsible thing to do.

My husband was diagnosed with a Glioblastoma (Grade 4 brain tumor). It was a tough pill to swallow because we had 3 sons, ages 12, 16, 18 and my husband was only 47. We were fortunate enough to be able to seek medical care at one of the top cancer centers in the U.S. M.D. Anderson Cancer Center, Houston. From the get go we were told his treatment would be palliative. They prepared us for his ultimate death with honest, open communication and respect for my husband and the kind of communication that informed us but also empowered us to live life....and not be consumed with DEATH. I am sure that if we would have stayed in our community for treatment, we would never have been prepared for the time when he died. Such a shame that in this day and age our doctors aren't prepared for end of life conversations. However, we do have social workers in hospitals, cancer centers, etc., whose basic tenet is advocating for their patients or clients. They will lead the way in end of life conversations to ensure that a person's wishes are followed. But the real responsibility lies within us and our families and communication is the only way.