Sunday, January 11, 2009

Minneapolis doctor criticizes the way we handle end-of-life


Craig Bowron, a physician who practices in Minneapolis hospitals, has a major op-ed in the Outlook section of the Washington Post this morning (Jan. 11), “The Dying of the Light: The Drawn Out Indignities of the American Way of Death”, link here.

A particular passage in the piece hits particularly hard:

“In the past, the facade of immortality was claimed by Egyptian kings, egomaniacal monarchs and run-of-the mill psychopaths. But democracy and modern medical advances have made the illusion accessible to everyone. We have to rid ourselves of this distinctly Western notion before our nation's obesity epidemic and the surge of aging baby boomers combine to form a tsunami of infirmity that may well topple our hospital system and wash it out to sea.”

I thought, this belongs in the Washington Times, not the Washington Post. Or does it? Social conservatives are always extolling family unity and preserving life at any cost, with mandatory loyalty of family members. But conservatives should be worried that the spiraling cost of end-of-life care, both in the medical and custodial areas, is doing as much to bankrupt our whole economy as is Wall Street.

And conservatives are right in that many of the specific medical issues Bowron discusses in his piece are lifestyle or behavior-based. There seems to be no room left for gratuitous emotion.

I didn’t see this piece in the Minneapolis papers (the Star Tribune). I lived in Minneapolis myself from 1997-2003 and got to know the Minnesota health care system when I had my acetabular (from a convenience store fall) fracture in early 1998. I had one of the top surgeons in the nation and recovered very quickly, and went back to work quickly (at age 54). Interesting.

With the elderly, Again, we’ve learned how to keep people alive, but not to keep them active. That sounds in marked contrast to how management of HIV disease has turned out (it looked so unsurmontable in the 1980s) where drug therapies can not only extend life now for decades but get people back to work.

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