With America’s “crazy tree” in full bloom over public discussion of health care reform (and everything else we’re afraid of in a society that is facing it’s biggest economic downturn since the Great Depression), the question of end-of-life counseling has been forced into the spotlight.  While some have managed to intentionally (and preposterously!) mangle the notion of palliative counseling into the advent of purported “death panels,” I am hopeful that we can take a step back and contemplate the larger question: what type of spiritual help do we (or should we) provide to the dying?

In Sogyal Rinpoche’s Tibetan Book of Living and Dying, he makes a strong case that end-of-life care is a necessity.  In the chapter titled “Spiritual Help for the Dying,” he writes:

“Spiritual care is not a luxury for a few; is it the essential right of every human being, as essential as political liberty, medical assistance, and equality of opportunity.  A real democratic ideal would include knowledgeable spiritual care of everyone as one of its most essential truths.  Wherever I go in the West, I am struck by the great mental suffering that arises from the fear of dying, whether or not this fear is acknowledged. …In Tibet it was a natural response to pray for the dying and to give them spiritual care; in the West the only spiritual attention that the majority pay to the dying is to go to their funeral.  At the moment of their greatest vulnerability, then, people in our world are abandoned and left almost totally without support or insight.  This is a tragic and humiliating state of affairs, which must change.  All of the modern world’s pretensions to power and success will ring hollow until everyone can die in this culture with some measure of true peace, and until at least some effort is made to ensure this is possible.”

What is wrong with a government — with our government — sanctioning this type of deeply personal care, perhaps even elevating it to a unwritten right?  People obviously have different notions of what happens at the time of death, but generic counseling not associated with any type of religious or spiritual tradition is available.  At my Grandma’s hospice, which was run by a Protestant group that made no attempt to hide the fact, the materials provided to our family made no mention of God or Heaven, but instead tried to prepare us for the physical and mental states that Grandma would experience in her final days.

Clearly, the public dialogue on this subject has been twisted in order to meet the self-serving political needs of a group I can’t even begin to understand.  And it’s regretful that, in order to try and focus the debate, the powers that be have taken end-of-life counseling off the table as a discussion point.  But, as Sogyal Rinpoche so bluntly puts it, “What does it really mean to have the technology to send people to the moon, when we do not know how to help our fellow humans die with dignity and hope?”