Before 1950, most Americans
died at home, from what were once familiarly described as “natural causes.”
By the 1980s, only about 1 out
of 6 deaths occurred at home—most folks died in hospitals or nursing homes. The
practice of medicine had expanded to embrace one’s last moments in an
institutional setting, instead of the relative comfort of one’s own bed.
The trend toward dying in a hospital bed has reversed itself. Data
from 2010 shows that about 45% of Americans departed this life in hospice care,
and more than half of those folks received hospice care at home. These U. S.
figures are among the highest in the world.
Dr. Atul Gawande writes in Being
Mortal: “…our most cruel
failure in how we treat the sick and the aged is the failure to recognize that
they have priorities beyond merely being safe and living longer; that the
chance to shape one’s story is essential to sustaining meaning in life; that we
have the opportunity to refashion our institutions, our culture, and our
conversations in ways that transform the possibilities for the last chapters of
everyone’s lives.”
Dr. Gawande explores the often
un-mentioned truth that simply “living as long as possible” isn’t the real wish
of many people, and probably isn’t what most people really want.
“We’ve been wrong about what
our job is in medicine. We think our job is to ensure health and survival. But
really it is larger than that. It is to enable well-being. And well-being is
about the reasons one wishes to be alive.” (1)
Most folks say that “quality of
life” is most important at the end.
Read Being Mortal.
Take some time to think about
what “quality of life” means to you.
Talk to your doctor and your
loved ones about it.
(1) Atul Gawande, Being Mortal: Medicine and
What Matters in the End (New York: Metropolitan Books, Henry Holt and Company,
2014), 6, 193, 243, 259.
Copyright © Richard Carl Subber
2015
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