On Death and Dying

dyingOk, so it’s not the most uplifting title of a post, but it’s one that’s been on my mind the past few weeks as I researched and interviewed people for a story on end-of-life issues. I’ll post a link to the story when it appears in Consumer Reports later this summer, but I’d just like to riff a bit about the way we view dying in this country.

The first thing we don’t seem to realize is that we are all going to die. I’ll say it again. We. Are. All. Going. To. Die. No matter how much medical technology we throw at it, something is going to kill us. So the question becomes, as one of my experts said, how do you want to die?

Do you want to die in a hospital or nursing home, in pain, vomiting from the last round of chemotherapy you had two weeks ago even though you and your doctors knew it was pretty useless? Well, up to half of patients with incurable cancer receive chemotherapy within the last month of life, notes one study. In fact, the American Society of Clinical Oncology lists late-life chemotherapy as one of five things that should be stopped in order to improve quality of life and reduce costs.

What if you have late-stage ALS (Lou Gehrig’s disease)? You’re incapable of moving, on a ventilator, only your mind and eyes still active. You get an infection. Do you want antibiotics?

These are questions we all — no matter what our age — need to consider. For without a legal document–a living will (advanced directive) and durable power of attorney (giving someone else the authority to act on our behalf if we can’t)–we have no control over how we die.

And if you’re already quite sick or old, and likely to die within the next year or so, you should complete a POLST–physician orders for life-sustaining treatment. Did you know that without these medical orders, EMTs cannot abide by any of your wishes regarding life sustaining treatment, even if you have an an advanced directive?

I’ll be writing more about this in the coming weeks; but for now, I urge you to make sure you have your documents in order, have a conversation with your loved ones, and then go on living life as fully as possible–knowing that you’ve taken an important step in dying as well as you live.


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