Death in America Is Getting More Painful

[n2doc]

It’s been more than 15 years since the Institute of Medicine released its seminal 1997 report detailing the suffering many Americans experience at the end of life and offering sweeping recommendations on how to improve care.

So has dying in America gotten any less painful?

Despite efforts to build hospice and palliative care programs across the country, the answer seems to be a resounding no. The number of Americans experiencing pain in the last year of life actually increased by nearly 12 percent between 1998 and 2010, according to a study released Monday in the Annals of Internal Medicine. In addition, depression in the last year of life increased by more than 26 percent.

That’s the case even though guidelines and quality measures for end-of-life care were developed, the number of palliative care programs rose and hospice use doubled between 2000 and 2009.

more

http://www.theatlantic.com/health/archive/2015/02/death-in-america-is-getting-more-painful/385230/

[Warpy]

1. Most people are simply never offered palliative care and/or hospice

and don't realize the options exist. It's good old fashioned medicine, disease fought until the last breath leaves the patient (and beyond), no matter what it costs him/her.

Add to that a lot of docs (and nurses) out there who were taught to avoid giving narcotics whenever they could get away with it and you have a prescription for dying in agony, approved of by the DEA.

The DEA is one of the greatest enemies of the American people. Without them, we might have adopted the UK system of handing a patient with a potentially lethal disease a bottle of Brompton's to be refilled as needed, no questions asked, whether or not aggressive treatment was being pursued. Here we have a system where pain pills are doled out parsimoniously by people who have to fill out complicated paperwork over every single pill with the DEA breathing down their necks if some bit of minutiae isn't completed to their satisfaction.

One example I saw was when a patient was in sickle cell crisis, one of the most intensely painful things a person can go through. A doc ran to the pharmacy and grabbed a vial of morphine for me to mix up for a morphine drip. It was a crisis situation and the doc didn't stop to do the paperwork. Cue massive drama and his residency threatened because the patient had been more important than completing paperwork on time. When a person is smashing his head into a wall to make the pain stop, you kinda want to shove in some morphine sooner rather than later and the wimpy doses on the med cart just didn't do it.

So this study doesn't surprise me in the least. The Drug War is vastly more important than the dying and too many of the dying don't know what options might be available to them.