Although it is summer and I know we all prefer something light to read, I strongly urge you to check this out. This article changed my perception of hospice and highlighted for me how complicated these issues are. Although hospice typically begins when a patient has agreed to stop treating their illness and to accept palliative care, hospice can actually extend the patient’s life. In one study, patients with Pancreatic cancer who began hospice lived three weeks longer than those who did not. Anyone with a terminal illness of course wants to live as long as they can. However, when asked, patients have other priorities that may be just as important: avoiding suffering, being with family, not being a burden. Unfortunately, traditional approaches that focus solely on aggressive treatment do not address these goals. Dr. Gawande makes the point that there is nothing wrong with fighting a terminal illness with every available medical option as long as the patient and their doctor also prepare for the more probable outcome (death) so that the patient’s remaining time is not shortened or dramatically diminished.
The article mentions a study of elderly, terminal patients in La Crosse, Wisconsin. Elderly patients in La Crosse have amazingly low end of life hospital costs. They spend half as many days in the hospital as the national average. Otherwise, they meet national averages for smoking and obesity. Eighty-six percent of these patients have advanced directives. I guess that is one of the main points I took away from this article. As elder law attorneys we are constantly telling our clients that they need advanced directives. Even more importantly they need to discuss end of life issues with their families.
Keep in mind that these discussions do not always mean ending treatment. The article describes Jack Block, a professor emeritus of psychology at UC Berkley, who was faced with life - threatening surgery. He named his daughter as his health care agent. To help her make decisions regarding end of life treatment, he told his daughter that she should allow the treatment if it would enable him to eat chocolate ice cream and watch football on tv. At first read, it seemed kind of simple but for this family, applying that standard really worked. This article is thought provoking and the more we all talk and discuss this issue the better. Read the full article here.