Lessons on dying, to be learned from doctors

Doctor Elizabeth (Lissa) McKinley is in the last few months of her life and is receiving hospice care at her home in Cleveland Heights. Lissa's sister Brent McKinley organizes her medication.

A New England pediatrician – writing under the pseudonym Russell Saunders – wrote an article in the Daily Beast today about a new study that confirms something we’ve known for years: Physicians do not want to prolong the end of their lives unnecessarily.

An overwhelming number of them (88 percent) said they would want an “advance directive that would stipulate ‘do not resuscitate’ (or DNR) status at the ends of their lives,” Saunders wrote, something I, too, learned as I wrote an article for Marketplace and the New York Times last fall:

“When it comes to dying, doctors, of course, are ultimately no different from the rest of us. And their emotional and physical struggles are surely every bit as wrenching. But they have a clear advantage over many of us. They have seen death up close. They understand their choices, and they have access to the best that medicine has to offer.” 

Examining the choices doctors make about their own final days can help the rest of us. While most people want to die at home, Medicare data shows that more than 50 percent of patients spend their final days in the hospital or a nursing home.

Part of the problem is most patients don’t know when the game is up. Simply, it’s hard for someone who lacks medical training to know whether there’s a chance to throw that Hail Mary and still win the game. Doctors know better.

The question is how to get our physicians to do a better job giving us the kind of information they have, thanks to their training and exposure to life-and-death situations. One obvious answer is to pay doctors to sit down and have these conversations with their patients.

It’s clear talking about death is difficult, sometimes near impossible. That’s true for some physicians, too. But as this new study suggests, doctors are arguably more thoughtful than the general public. And that gives doctors a chance to consider carefully whether the next procedure they order for their dying patient is a procedure they would order for themselves.

About the author

Dan Gorenstein is the senior reporter for Marketplace’s Health Desk. You can follow him on Twitter @dmgorenstein.

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