Doctors have the very best medical care at their fingertips. They read journals that publish the latest medical findings; they know the most up-to-date treatments for various ailments and diseases; they might even play golf with a top surgeon or two. And yet, when faced with death, many physicians forgo intensive medical treatment.
Doctors “don’t die like the rest of us,” writes Ken Murray for Zócalo Public Square, primarily because “they know enough about modern medicine to know its limits.” Most medical professionals regularly see futile care in action—ineffective CPR attempts, unnecessary surgeries, and expensive drug treatments; patients hooked up to hospital IVs and machines for weeks or months before passing.
“I cannot count the number of times fellow physicians have told me, in words that vary only slightly, ‘Promise me if you find me like this that you’ll kill me’” says Murray, a clinical assistant professor of family medicine at USC. “They mean it. Some medical personnel wear medallions stamped ‘NO CODE’ to tell physicians not to perform CPR on them. I have even seen it as a tattoo.”
Our medical system certainly encourages doctors and staff to take exhaustive measures when a patient is dying. The fee-for-service model puts money in the pockets of medical professionals, and desperate relatives often push for recovery by any means necessary. But many doctors recognize there are more important things than the number of days we breathe on this earth. Murray offers one example:
Years 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.
At-home care can be an attractive, viable option, according to Murray:
Almost anyone can find a way to die in peace at home, and pain can be managed better than ever. Hospice care, which focuses on providing terminally ill patients with comfort and dignity rather than on futile cures, provides most people with much better final days. Amazingly, studies have found that people placed in hospice care often live longer than people with the same disease who are seeking active cures.
That doctors opt out of traditional end-of-life care might make us reconsider the measures we would take for our loved ones or ourselves. Read the moving story “When the Last Guest Leaves,” featured in our current issue, to see how one woman—with the help of her son—chooses a dignified death outside hospital walls.