What Doctors Know About Death

Ken Murray has an excellent column in today’s WSJ called “Why Doctors Die Differently.”  Here’s a sample:

“Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach.  It was diagnosed as pancreatic cancer by one of the best surgeons in the country, who had developed a procedure that could triple a patient’s five-year-survival odds — from 5% to 15% — albeit with a poor quality of life.

“Charlie, 68 years old, 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 his family.  Several months later, he died at home.  He got no chemotherapy, radiation or surgical treatment.  Medicare didn’t spend much on him.

“It’s not something that we like to talk about, but doctors die, too.  What’s unusual about them is not how much treatment they get compared with most Americans, but how little.  They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care that they could want.  But they tend to go serenely and gently.

“Physicians really try to honor their patients’ wishes, but when patients ask ‘What would you do?,’ we often avoid answering.  We don’t want to impose our views on the vulnerable.

“The result is that more people receive futile ‘lifesaving’ care, and fewer people die at home than did, say, 60 years ago.”  Emphasis added.