Doctors Die Differently

Mar 7, 2012 | 0 comments

A number of columns and articles on how doctors approach end-of-life care for themselves have appeared recently. Patients, take note: doctors choose quality of life over quantity of time almost every time. Do you have advance medical directives in place?

A column by Ken Murray that appeared in The Wall Street Journal and was excerpted in The Week‘s March 9 issue said:

Most doctors die differently than their patients. When our time comes, those of us who’ve spent our lives in the health-care system tend to decline aggressive treatment to save our lives…

Having seen so many people die, doctors know that “heroic measures” to prolong life often succeed only in providing a few extra weeks or months of suffering and indignity.

Unfortunately, most people would rather not think about death, so only 20 percent have written living wills that give them “control over how their lives end.” That’s a pity; the time to think about this is now. Like most doctors, I have made it clear that when my time comes, “I will go gently into that good night.”

On, physician and financial planner Carolyn McClanahan just posted a piece, How to Die Like a Doctor. Here’s the intro:

With the interest lately in how doctors die, now is a great time to help you plan to die like a doctor.  In my last post, I discussed how doctors are great at completing their end of life planning, and they make certain the right people are in place to carry out their wishes.  They also tend to take charge of making certain their loved ones have the most pleasant end of life possible.

When doctors choose how to treat their terminal illness, they take prognosis into account.  If prognosis is not good, most opt for comfort care and conservative treatment.  Ideally, a death well prepared for is a more comfortable death, and this is what doctors choose.  So what can you do to die like a doctor?  It takes some preparation, and for most, a change in how life and death are viewed.  I’ll break this down into phases – pre-illness, illness, and too-late-to-cure illness.  This is a lot to cover, so it will take a few posts.

Check out her posts – there’s a lot of great information she provides and timely tips.

And USA Today just ran a story yesterday titled “Best Care” may be dying well say hospice, palliative care docs. Medical advances help people live longer and longer, but too few physicians help people understand that longer is not always better, according to two new books.

The books are The Best Care Possible, a Physician’s Quest to Transform Care Through the End Of Life by Ira Byock and What Really Matters, 7 Lessons for Living from the Stories of the Dying by Karen Wyatt.

Byock says the needless suffering at the end of life is partly a result of a current political climate that accuses palliative care doctors and hospice physicians of promoting a “culture of death” or “death panels.” Rather, he writes, he is one of the compassionate experts who are “pro-life” and insist people get the best care possible — basically what they want for themselves — and no extra care.

“Most doctors have been trained to treat diseases and not deal with end-of-life issues,” he says. “American medical prowess is wonderful, but we have yet to make a person immortal. At some point, more disease treatment is not better care.”

People have to think about quality of life but also quality of death, he says, adding that it’s important that doctors don’t give up too soon on someone while also knowing the limitations of treatment.

“I think physicians have really fallen short on that obligation,” says Wyatt. “They haven’t been as helpful to patients as they could have been.”

So if doctors plan ahead and seek a peaceful passing, why don’t their patients? Everyone wants to go to heaven but no one wants to die to get there. Time to have some serious conversations, folks.

A Good Goodbye