February 8th, 2011 by Debra Gordon in Better Health Network, Opinion
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The recent Washington Post article entitled, “Who decides when medicine prolongs dying, not living?” perfectly captures my earlier blog on why we’re afraid of death. An excerpt from the Post piece:
[There’s a] huge gap between Americans’ wishes about end-of-life care, as expressed in numerous public opinion polls, and what actually happens in too many instances–futile, expensive, often painful procedures performed on people too sick to leave the hospital alive–much less survive with a decent quality of life. Ninety percent of Americans say they want to die at home but only 20 percent do so. Half of Americans die in hospitals and another 25 percent in nursing homes, after a long period of suffering from chronic, incurable conditions that finally become untreatable. An astonishing one out of five die in intensive care units, often unconscious, isolated from loved ones and hooked up to machines that do nothing but prolong an inevitable death.
This happens partly because of the natural human tendency to procrastinate about addressing painful subjects with relatives and partly because doctors are often too pressed for time–and too uncomfortable with death and dying themselves–to respond when patients do bring up such issues. Just try to get a straight answer out of an oncologist, as an 89-year-old friend of mine did when her doctor advised another course of chemotherapy even though her cancer had metastasized to her brain. “Doctor,” she asked, “what chance is there that I’ll have a few months more of life that I can enjoy with my family?” He replied, “We can’t know these things.” She replied, “No, but we can use our common sense,” and declined further treatment. She died a month later in hospice, surrounded by her children, grandchildren and great-grandchildren. What if she hadn’t been clear-minded enough to to speak for herself? What if her children, out of love, guilt or a combination of the two, had subjected her to treatment that she wouldn’t have wanted? That is what advance medical directives are intended to prevent. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
January 7th, 2011 by Debra Gordon in Better Health Network, Opinion
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My cousin’s mother-in-law is in her late 90s. She had horrible osteoporosis and can barely move. She has little cognitive function left. She requires nearly 24-hour care and no one would even attempt to say she has any quality of life left. She told her son years ago that she was “ready to go,” and had had enough.
And yet when I asked my cousin’s husband if his mother had any do-not-resuscitate orders, or had ever completed an advanced director outlining her wishes of what kind of end-of-life care she wanted, he said no. His sister, he said, just wasn’t ready for that yet. So what, I asked, will you do when/if your mother gets pneumonia? Will you treat it with antibiotics? Will you put her on a respirator? If she is no longer able to eat, will you feed her through a tube?
He couldn’t answer. And he was clearly uncomfortable with the questions. Read more »
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
November 27th, 2010 by DavidHarlow in Better Health Network, Health Policy, Health Tips, Medblogger Shout Outs, News
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As patients, as family members, as friends, as health care providers, we have all faced end-of-life issues at one time or another, and we will face them again. And again.
This weekend the “Engage With Grace” message is being broadcast virally, through a “blog rally,” at a time when many people are with family and friends over the long weekend. The point is: We all need to have the potentially uncomfortable conversation with people close to us about what kind of treatment we would want, and they would want, if incapable of making or communicating healthcare decisions. CNN ran a story on “Engage With Grace” yesterday.
End-of-life decision-making has long been an issue of great personal and professional interest to me, and I am proud to have played a role in having out-of-hospital DNR orders recognized in Massachusetts by EMS providers, as an example. Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
July 17th, 2010 by Edwin Leap, M.D. in Better Health Network, True Stories
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Yesterday I had a university student shadowing me in the emergency department. AF is a bright student, a hard worker who will make a wonderful physician. She is always curious and insightful when I ask her questions, or show her new things. Today, she saw something that was new for her, but perhaps too common for me.
I walked into the room of an infirm, frail old gentleman who was gracious and polite, as was his family. It turns out he came to us with a terminal illness. I did not know it, but his physician was meeting him. So, as AF and I walked into the room, the patient’s physician walked in after us, and continued a conversation about hospice that he had apparently begun earlier in the day.
Realizing I had nothing to add, and would not be needed, I slipped away with my shadow behind. She looked at me, tears welling, and excused herself. Later she returned and explained that when she saw the wife’s wedding band, and knew what hospice meant, she could not restrain her tears. Read more »
*This blog post was originally published at edwinleap.com*
June 19th, 2010 by AndrewSchorr in Better Health Network, Health Tips, Opinion, True Stories
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Esther and I went away last weekend for a much needed break from kids, the normal routine, and pets that can wake us up when daylight arrives here in the Pacific Northwest at 5am.
We stayed at a quaint bed and breakfast called “The Blue Goose” in the small town of Coupeville, Washington, on Whidbey Island northwest of Seattle. It was restful and, with great sunny weather, rejuvenating.
At a bed and breakfast, of course, you typically chat with other people over coffee, egg soufflé, and bran muffins. The experience can be tiresome and too chatty. But sometimes it can be riveting.
It was the latter the other morning as we chatted with Diane about health matters and she shared her pain about two episodes in her life. Read more »
*This blog post was originally published at Andrew's Blog*
