Wednesday, January 14, 2009

WaPo On Death in America

Washington Post recently published a commentary, written by a hospitalist, about the modern American way of dying. Well written, with lots of familiar patient scenarios. It tends towards the philosophical side, and seems to place the burden of the problem on patients, the culture at large, etc., as opposed to our medical system and culture. Of course that's a problem, but I don't think it's one that any clinician is going to fix, and the question for us clinicians is how can we impact this within the medical system (as we are not going to revolutionize our overall society's approach to death and dying)? Anyway - worth a read:

Everyone wants to grow old and die in his or her sleep, but the truth is that most of us will die in pieces. Most will be nibbled to death by piranhas, and the piranhas of senescence are wearing some very dull dentures. It can be a torturously slow process, with an undeniable end, and our instinct shouldn't be to prolong it. If you were to walk by a Tilt-A-Whirl loaded with elderly riders and notice that all of them were dizzy to the point of vomiting, wouldn't your instinct be to turn the ride off? Or at the very least slow it down? Mercy calls for it. This isn't about euthanasia. It's not about spiraling health care costs. It's about the gift of life -- and death. It is about living life and death with dignity, and letting go. In the past, the facade of immortality was claimed by Egyptian kings, egomaniacal monarchs and run-of-the mill psychopaths. But democracy and modern medical advances have made the illusion accessible to everyone. We have to rid ourselves of this distinctly Western notion before our nation's obesity epidemic and the surge of aging baby boomers combine to form a tsunami of infirmity that may well topple our hospital system and wash it out to sea.

At some point in life, the only thing worse than dying is being kept alive.

Thanks to Dr. Fred Holm for alerting me to this.

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