When not to resuscitate

Printed in the Iowa City Press-Citizen, Aug. 15, 2009.

"And I don't have any problem with things like living wills. But they ought to be done within the family. We should not have a government program that determines if you're going to pull the plug on Grandma" -- Sen. Chuck Grassley.

After listening to Iowa Sen. Chuck Grassley's now infamous comment Wednesday, I thought I'd call Mary Wohlford of Dyersville and ask what she thought about all the hoopla surrounding imaginary "death panels" and the provision for "advance care planning consultation" in the U.S. House version of the health care overhaul bill.

Three years ago, a then 80-year-old Wohlford made news worldwide after she tattooed "Do Not Resuscitate" on her chest. A longtime nurse with experience in emergency rooms and hospice care, Wohlford knew full well that medical practitioners usually would err on the side of keeping a patient alive if there was any question about the patient's wishes -- or if there was any risk of a lawsuit from the patient's family.

Wohlford's attempt to make sure her intentions were as clear as possible proved to be an attention-grabbing reminder that we all need to write down our wishes and to talk about them with medical practitioners, family members and friends.

Now 83, Wohlford said she is in excellent health -- "I don't take any pills except for vitamins" -- and continues to live in the house she's still been in for more than 50 years. And she recently attended one of Grassley's other outdoor meetings.

Wohlford said she is no supporter of the Obama administration -- "I'm too pro-life, both at the beginning of life and at the end." And she views the current efforts for health care reform as being little different than those in 1993.

Her own solutions for driving down the costs of health care include:

• Capping the monetary damages awarded in malpractice lawsuits.

• Controlling the lobbying power of pharmaceutical companies.

• Limiting the unnecessary diagnostic procedures she said doctors only do to avoid lawsuits.

Wohlford strongly emphasized that she's neither for abortion nor euthanasia, but she wants to make sure she has a "natural end" after living for so many years. She doesn't want "10,000 tubes put in." She just wants to die a "natural death."

Wohlford said while she disagrees with much of the current proposals for health care reform, she does think people would benefit from talking about end-of-life care with "someone knowledgeable to explain to we old people how we can make up our own minds."

Legal and medical experts in Iowa say that Wohlford's tattoo by itself wouldn't be enough to prevent extraordinary measures from being taken to prolong her life.

But Wohlford -- who expects she has at least another 10 years in her -- is taking the other necessary steps for advance care planning:

• Discussing her preferences with her family.

• Writing a living will about which life-saving procedures she does not want.

• Appointing someone to make such life-and-death decisions for her if she is incapacitated.

Wohlford said her next job is to find a replacement for the tattered "National Health Insurance/Don't Get Sick" bumper sticker she's had on her car since the Clinton years.

"You have to rattle the cage every once in a while," she said.

Opinion editor Jeff Charis-Carlson can be contacted at jcharisc@press-citizen.com or 319-887-5435.