Award-winning journalist Katy Butler is riding a wave of positive publicity for her new book, Knocking On Heaven’s Door, a personal examination of how modern medical technology is used to prolong unnecessary suffering at the end of life for millions of Americans. Butler, a veteran journalist whose latest effort is garnering praise from academics and health care professionals , shared with Life Matters Media her thoughts about end of life planning, hospice care and the media’s role in stimulating discussions about death and dying.

My personal feeling is that these discussions should not even be framed as end of life discussions. These conversations should be described as meaningful conversations for full, informed consent for any medical procedure. I’m a big fan of this whole approach called ‘slow medicine,’ which is not just for the end of life, but also for careful reimbursement for extensive time spent with doctors so that they know their patients. Decisions would really fit the values of patients. And patients tend to be more conservative than their doctors, at least from the research I’ve seen.

Language to reimburse physicians for end of life counseling was taken out of President Obama’s health care overhaul. As some senators are seeking to enact such legislation , how do you feel about the debate regarding end of life planning?

I would like them to remember that the most loving thing to do for a loved one may not look kind to the outside world. With my dad, it was a kindness from me to remove any obstacles for a natural death for him. I hope my book helps people understand that loving someone means alleviating their suffering, not always maximizing longevity.

What would you like your readers to take away from your book?

I think the problem is people are really not informed about pros, cons and alternatives to treatments that they are getting or offered. They certainly are not counseled to pay attention to long-term implications about quality of life for various surgeries. It’s unfortunate that these conversations are only being framed as end of life counseling, because then it becomes vulnerable to the ‘death panel’ argument.

My father got a pacemaker at a point when that was never conceived of as an end of life discussion, but it was a quality of life discussion. My parents did not get information they needed, especially for the alternatives that were being suggested.

Why are such conversations so uncommon in the U.S.?

I think we’re in love with technology and willing to forget about tradition in ways that European countries are not. We kind of believe that advances in medical technology can postpone death forever– like there is no such thing as aging. Europeans tend to counterbalance that with more faith in tradition. Like the timeliness of needing to face death and dying or having rituals about death and dying. We are sort of anti-tradition and pro-technology, so we have no moral guidance for these major decisions or for coping with the death of someone you love.

It was a kindness from me to my dad to remove any obstacles for a natural death.

Does religion influence one’s views about death and dying?

In the 1400s, there were best-selling books on the art of dying- they were manuals on how to behave on your own death bed. They were religious texts. We had those traditions through the 1800s, and now we don’t have them at all. It’s like a 180. Hundreds of years ago the virtuous person accepted death as part of God’s will and plan. Now, if you read obituaries a lot of people believe that the virtuous person fights against death and battles it until the end.

When should seriously ill individuals begin thinking about hospice care?

I think we should triple the daily hospice benefit payment and at least lengthen the hospice benefit to a year, if not two years. Anyone in their last five years of life should begin having these conversations. Many doctors, patients and families overestimate how long someone is going to live. I was still shocked and surprised when my dad died, because I thought he had at least six to eight months left. One way to start these discussions could be to ask your doctor, ‘Doctor would it surprise you if I died within a year?