How Not to Die

[xchrom]

http://www.theatlantic.com/magazine/archive/2013/05/how-not-to-die/309277/

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Dr. Angelo Volandes is making a film that he believes will change the way you die. The studio is his living room in Newton, Massachusetts, a suburb of Boston; the control panel is his laptop; the camera crew is a 24-year-old guy named Jake; the star is his wife, Aretha Delight Davis. Volandes, a thickening mesomorph with straight brown hair that is graying at his temples, is wearing a T-shirt and shorts and looks like he belongs at a football game. Davis, a beautiful woman of Guyanese extraction with richly braided hair, is dressed in a white lab coat over a black shirt and stands before a plain gray backdrop.

“Remember: always slow,” Volandes says.

“Sure, hon,” Davis says, annoyed. She has done this many times.

Volandes claps to sync the sound. “Take one: Goals of Care, Dementia.”

[bemildred]

1. Excellent.

This is a problem, because the assumption that doctors know what their patients want turns out to be wrong: when doctors try to predict the goals and preferences of their patients, they are “highly inaccurate,” according to one summary of the research, published by Benjamin Moulton and Jaime S. King in The Journal of Law, Medicine & Ethics. Patients are “routinely asked to make decisions about treatment choices in the face of what can only be described as avoidable ignorance,” Moulton and King write. “In the absence of complete information, individuals frequently opt for procedures they would not otherwise choose.”

It's not the things you don't know that get you, it's the things you know that ain't so.

[peace13]

2. Thank you for this!

My sister, 58 years old, is very ill and is in a special care ( locked dementia unit) unit. I have been her caregiver for over three years and could write a book. There is so much need in this area, so much pain, confusion, mental and physical suffering. Unlike the aide in this article, my sisters caregiver just can' t believe that we won't put a feeding tube in.

Three years into it and so many of our new friends have died. Such sad, lonely, painful deaths!

[winter is coming]

4. I think what some health care professionals can't understand is that

there are all sorts of interventions that patients/relatives may be willing to undergo if there's a reasonable chance that things will get better. When the patient is likely to lose their life (physical and/or mental), it can be a different story.

to you. I know this must be a very painful, trying time in your life.

[peace13]

5. Thanks so much for the kind words! n/t

[CanSocDem]

3. Excellent.

From your link:


"We torture people before they die,” Davis interjects, quietly.

..................................................................................................................

Volandes nods. “Here’s the sad reality,” he says. “Physicians are good people. They want to do the right things. And yet all of us, behind closed doors, in the cafeteria, say, ‘Do you believe what we did to that patient? Do you believe what we put that patient through?’ Every single physician has stories. Not one. Lots of stories.

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Unwanted treatment is American medicine’s dark continent. No one knows its extent, and few people want to talk about it. The U.S. medical system was built to treat anything that might be treatable, at any stage of life—even near the end, when there is no hope of a cure, and when the patient, if fully informed, might prefer quality time and relative normalcy to all-out intervention.


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