Best to think ahead about the unthinkable

To the editor:

I applaud The Eagle for having the courage to print Deborah Alecson's excellent, thought-provoking May 2 article "Death-phobic culture lingers in 'gray zone.'" Her article reminded me of the great importance of thinking ahead, not only about the most inevitable thing in life (i.e., our death), but also about the possibility of a life-limiting condition in a newborn baby.

As adults, we have the choice to plan for how we want the end of our lives to be. Yet many of us avoid doing so. No wonder that it's even harder to plan for the life or death of a child, should pregnancy or birth suddenly take an agonizing turn.

Most of us would much prefer to dream about our babies' nurseries, schools, wardrobes, etc., rather than consider what we would do if we were told, before or just after the birth, that our baby might not survive without certain major medical interventions, perhaps involving risk, pain, or dependency on medical technology, perhaps short-term, or maybe for life. Many of us carefully plan and save to fund our children's daily needs and future education, but which of us has even looked through our insurance policy to determine the coverage for a child's extraordinary medical needs? Or considered how such needs may impact the family?


As a psychotherapist and hospice social worker, I've met many people who have been blind-sided by unforeseen or uncontrollable life circumstances. I've counseled many who have made decisions in the midst of crisis that they later regret. These people have taught me that thinking ahead about the "unthinkable" — whether it be one's own death, or the possibility of life threatening condition in a newborn child — can prevent having to make life-changing decisions during a crisis, when emotions are overwhelming, and clear, rational thought is extremely difficult.

It is important to view our health care providers as a team offering clinical expertise but also needing input from us, the patients and parents of dependent children, to know how we want them to proceed. All benefit from a clear idea of the spiritual, moral and ethical, social and financial elements that drive our decisions about our lives and those of our loved ones.

Advance directive documents such as the health care proxy, living will, MOLST (medical orders for life-sustaining treatment), and "Five Wishes" are available for free in many health care settings. Mental health and spiritual counselors can help prospective parents consider all facets of what it means to be responsible for the life of a child. Having these conversations in advance can provide a vital road map through some of the most challenging times in the life of a person and his/her family.

Jane Salata, Lenox