Taking responsibility for death

Susan Jacoby has a nice piece in the NY Times recounting the story of how her mother faced her death–clear eyed and asking questions about what medical treatments could realistically provide for her, and then making decisions based on her preferences. This is a good story to emulate.

It will be hard to revolutionize our cost problem by focusing on the issue of spending near death alone, in part because it is not clear when the last year of life started until it ends, and in part because our culture goes vaguely insane with charges of death panels, etc. Instead, we need need to more comprehensively ask three questions: will this improve my quality of life? will it extend my life? how much does it cost?

The asking of these questions will likely be the most consequential in terms of cost near the end of life, but we need to learn to ask them all the time as a matter of course if we are to become comfortable with them as a loved one is dying.

About Don Taylor
Professor of Public Policy at Duke University (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute). I am one of the founding faculty of the Margolis Center for Health Policy, and currently serve as Chair of Duke's University Priorities Committee (UPC). My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

2 Responses to Taking responsibility for death

  1. steve2 says:

    I think this needs to start way before the end of life. This story is very nice, but in reality the people making these decisions are often in pain, are confused or exhausted or unable to understand their choices. What I see over and over is that when people are not prepared, they opt for “do everything”.

    Steve

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