The average American will undergo medical treatment that costs one-third of all his lifelong medical costs during the last year of his life. The treatment that he then receives will often result in an extremely poor quality for his extended life. Doctors, for the most part, do not allow themselves to be put through such a wasteful nightmare:
“It’s not something that we like to talk about, but doctors die too. What’s unusual about them is not how much treatment they get compared with most Americans, but how little. They know exactly what’s going to happen, they know the choices, and they generally have access to any sort of medical care that they could want. But they tend to go serenely and gently…In a 2003 article, Joseph J. Gallo and others looked at what physicians want when it comes to end-of-life decisions. In a survey of 765 doctors, they found that 64% had created an advanced directive – specifying what steps should and should not be taken to save their lives should they become incapacitated. That compares to only about 20% for the general public.” Ken Murray, ‘Why Doctors Die Differently’, The Wall Street Journal, February 25, 2012
Nursing professor Karen Kehl ranks the attributes of a graceful death as including being comfortable and in control, having a sense of closure, making the most of relationships, and having family involved in care. Hospitals provide few if any of those qualities. At enormously high cost, they allow their patients to eke out their final weeks (or months) drugged out of consciousness, fed by drips, in semi-private rooms, visited infrequently by family and friends, often in the presence of strangers.
Ken Murray, a retired clinical professor of family medicine, knows from personal experience that there is a better and a much cheaper way to live out one’s final days:
Several years ago, at age 60, my older cousin Torch had a seizure. It turned out to be the result of lung cancer that had gone to his brain. We learned that with aggressive treatment, including three to five hospital visits a week for chemotherapy, he would live perhaps four months.Torch was no doctor, but he knew that he wanted a life of quality, not just quantity. Ultimately, he decided against any treatment and simply took pills for brain swelling. He moved in with me. We spent the next eight months having fun together like we hadn’t had in decades. We went to Disneyland, his first time, and we hung out at home. Torch was a sports nut, and he was very happy to watch sports and eat my cooking. He had no serious pain, and he remained high-spirited. One day, he didn’t wake up. he spent the next three days in a coma-like sleep and then died. The cost of his medical care for those eight months, for the one drug he was taking, was about $20.” Ken Murray, ‘Why Doctors Die Differently’, ibid.
Way to go, Torch! If only more Americans would think like him, would think indeed like doctors when making their own end-of-life decisions, the Medicare-funding nightmare would be no more.