Ezekiel Emanuel wrote an article for the Atlantic on "Why I Hope to Die at 75: An argument that society and families -- and you -- will be better off if nature takes its course swiftly and promptly."  As an oncologist and ethicist, he says he speaks for himself but implies not so subtlety that avoiding our declining years may be in our best interest -- and that it ...

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Human life is a gift.  Death, too, can be a gift.  Is it ever appropriate for us to choose the timing of our death? Brittany Maynard, 29, was diagnosed with a stage 4 glioblastoma, an aggressive and uniformly fatal brain tumor.  With the blessing of her family and millions of supporters around the world, she ended her life in Portland, Oregon, with a fatal dose of barbiturates prescribed by a physician.  ...

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What does a good death mean to you? In July 1991, I was beginning my first year of medical school in Rochester, New York. I was filled with excitement and anxiety on beginning a journey in medicine as I started on the road to becoming a doctor. At that time, Rochester was in the national spotlight because of the actions of one of our faculty members, Timothy Quill. ...

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Brittany Maynard has passed from this life.  This brave but unfortunate 29-year-old woman with incurable progressive brain cancer drew public attention by choosing to go public with her choice about end of life care. "Brittany suffered increasingly frequent and longer seizures, severe head and neck pain, and stroke-like symptoms," according to a statement Sunday night from Sean Crowley, spokesman for Compassion & Choices, a national nonprofit working to expand end-of-life ...

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Does Brittany Maynards decision affect the future of oncology? Would you base a life or death decision based on one doctor’s opinion? One research article? Google searches? What would it take? I recently read that Brittany Maynard took her own life. Plagued by glioblastoma, she chose to reject chemotherapy, radiation, and hospice. Tomorrow, I have a schedule packed with glioblastoma patients who personify courage, determination, and faith. Glioblastoma (GBM) ...

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The 75 Plan: Thoughts on Ezekiel Emanuels palliative care article When teaching about life near dying, it is hard to achieve open conversation.  No matter what one says in a lecture hall or what brilliant writers publish on the terrible state of end-of-life care, change is painfully slow.  While we blame evasion by doctors of challenging conversations, failure by patients to plan or denial by families which blocks open communication, the ...

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During my first year of medical school, in the last year of my father’s life, his oncologist had a difficult discussion with him and my mother- the decision to become do-not-resuscitate (DNR). I remember my mother was taken aback, my father was relieved and I was deeply saddened.  However, when I got the call that my father may not make it out of the hospital this last time, I was ...

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Not too long ago I suggested hospice to a patient who had progressive cancer, although she likely had months to live.  “I don’t think it is time,” she replied, “hospice is for morphine.” “That is not how I see hospice,” I replied, “I think hospice is about getting the best care and support, even if there is no real treatment for the disease.  It is about living well, maybe better. Even ...

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He had called the other day to update me up on his condition.  He did not sound upset, but resolute.  "They offered me peritoneal dialysis," he said, "but I decided against it and figured I'd just let nature take its course.  The hospice people are so wonderful -- I've got things all set here at home, but I have two questions.  What should I do about my warfarin?  You know, ...

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We’re born into our bodies, and we take that for granted. Our first job is to take a breath, something we’ll hopefully do many millions of times and never think about.  That first breath changes everything: Our blood starts to flow through our heart and lungs in a different way and for the first time we taste a new world. Before we’re born, all our needs are met via an artery and ...

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