Tuesday, February 28, 2012

Verbatim: "Why Do Doctors Die Differently?"

I was struck by a recent article of Dr. Ken Murray's in The Wall Street Journal because my own cardiologist father, who passed away fourteen months ago, was certainly of the same mind. "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 is going to happen, they know the choices, and they generally have access to any sort of medical care that they could want. Doctors don't want to die any more than anyone else does. But they usually have talked about the limits of modern medicine with their families. They want to make sure that, when the time comes, no heroic measures are taken. 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. Unlike previous eras, when doctors simply did what they thought was best, our system is now based on what patients choose. Physicians really try to honor their patients' wishes, but when patients ask "What would you do?," we often avoid answering. We don't want to impose our views on the vulnerable. The result is that more people receive futile "lifesaving" care, and fewer people die at home than did, say, 60 years ago. Written directives can give patients far more control over how their lives end. But while most of us accept that taxes are inescapable, death is a much harder pill to swallow, which keeps the vast majority of Americans from making proper arrangements. It doesn't have to be that way. As for me, my doctor has my choices on record. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night. Like so many of my fellow doctors." As an aside, I might say that "going gentle into that good night" is a worthy, but not always achievable, goal.  Advanced Directives (Personal Directives in Canada) can go a long way in the right direction, however, and relieve your family of significant decision-making stress during an emotional time.  See your lawyer today.