Addressing Gaps in End-Of-Life Planning

Kenneth Lin

Posted 3/15/12 on Common Sense Family Doctor

A recent article by family physician Ken Murray in the Wall Street Journal, titled “Why Doctors Die Differently,” observed that doctors are more likely than other people to decline end-of-life interventions that have little likelihood of benefit:

It’s not something that we like to talk about, but 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. But they tend to go serenely and gently.

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. During their last moments, they know, for instance, that they don’t want someone breaking their ribs by performing cardiopulmonary resuscitation (which is what happens when CPR is done right).

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How Doctors Die: Its Not Like the Rest of Us, But It Should Be

Ken Murray

Posted on Zocalo Public Square on 12/30/11

Brian’s Note: This article was alluded to in a NY Times blog post called “When Doctors Face Death.” In a clear and rational tone, the author, an experienced family physician, points out that, when American physicians face death, they often don’t want the excessive care that their patients generally receive. As I understand it, the article, part of a series for Zocalo Public Square, has gained tremendous traction. Rightly so. Read it below.

bio-ken-murray.jpgYears ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

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