Dying has become a difficult and often excruciatingly slow process.
So says Minnesota internist Craig Bowron as he talks about treating some of the elderly patients on his hospital service (via Duncan Cross). Often times, these cases are among the most difficult, with family members contradicting previously discussed advance directives.
“There are no life-saving medications, only life-prolonging ones,” Dr. Bowron eloquently states, adding that “medical advances have created at least the facade of choice. It appears as if death has made a counter-offer and that the responsibility is now ours.”
The options he alludes to are, for instance, between a feeding tube or dialysis versus death, and these choices “can be agonizing when you’re 80 and the bad days outnumber the good days two to one.”
Furthermore, Dr. Bowron writes that we need to adjust our expectations of death, and rid ourselves of the “distinctly Western notion” of the illusion of immortality.
We as a society have trouble letting go, and in doing so, fail to realize that “the only thing worse than dying is being kept alive.”
Good piece, and well worth reading in its entirety.
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- Malingering and the difficult patient.
- Doctors dealing with difficult patients, is it the fault of young physicians?
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{ 3 comments }
I was recently at a hospital meeting where I learned the hospital’s “stats’ were being hurt because we had started to do more and more palliative and end-of-life care. This has raised our observed mortality greater than what our expected would be. Just shows how deep into our culture and systems we’ve built in this fight death at all costs mentality.
Great article.
We touched on this at Pallimed as well.
Our current medicalization of dying does have a lot to do with the choices we make and the avoidance of wanting to address anything that may be bad. The answer is quite complex but I am concerned that increasing limited health care dollars will make this gentle transition to a broader acceptance of dying a hard one.
Thanks for highlighting this article Kevin!
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