Priorities

A group of clerics expressed interest Friday in U.S. Sen. Mark Warner's proposal to make end-of-life care part of the health care overhaul debate.

The Virginia Democrat told several dozen Christian and Jewish leaders that he wanted them to help him find ways to educate people about the sensitive issues of caring for dying people.

"We've got to figure out a way to talk about this," he said.

Warner has introduced legislation that would expand Medicare's hospice care for the terminally ill. Among other things, it would provide relief for family caregivers and offer more counseling on establishing living wills, which advise families on the wishes of incapacitated patients. He has said that with more advance planning and counseling,

end-of-life care can be less expensive and save Medicare about $15 billion over 10 years.

"This is not about denying or restricting anyone's health care options," he told the group at Talbot Hall, a center for the Episcopal Southern Diocese of Virginia.

The Very Rev. John Agbaje, rector of St. James Episcopal Church in Portsmouth, said early conversations about preparing for terminal care aren't common.

"By the time we get to the hospital, it's almost too late," he said.

Even trying organize a congregation discussion about terminal care is difficult, said Rabbi Rosalin Mandelberg of Ohef Sholom Temple in Norfolk.

"We find that people don't come because they're afraid," she said. "It's almost like talking about it will make it happen."

Perhaps the strongest approach is to use the medical professionals in congregations to advise members, said Sister Margaret McCabe, a Roman Catholic nun who is also a nurse practitioner. They understand the church's beliefs but also can explain the medical issues, she said.

"They have credibility within their own community."

Several ministers told Warner that, generally, church leaders don't have enough knowledge about end-of-life medical care and the kinds of early planning that people can make.

When asked by a minister how he felt about the chances that a health care overhaul bill will be passed, Warner clasped his hands, looked up at the ceiling and said, "Prayerful... I think there is a chance."