Human Exceptionalism

People Don’t Have to Die in ICUs!

Sometimes it is as if hospice never happened. People now often die at home, surrounded by loved ones, without heroic efforts forced upon the dying to keep them alive. Yet, those who want to have a “conversation” about death and increase “options” (wink, wink) talk as if people are still forced to be hooked up to ICU machines against their will, when the real problem these days–thanks to changes in the economics of medicine–is getting the machines when you want them. 

I bring this up because the LA Times ran a big story about a group that converses about death. From the story:

The way we die is about to change, Burzynski says. He’s convinced of it. Aging baby boomers will demand better options, and they know how to get things done. His mother, he says, grew up in a village. As a girl, she helped wash and lay out the bodies of the dead. Most deaths used to be at home, he says. Now that’s rare.”We all want to make a good death. If you ask anybody, ‘How do you want to die?’ they’ll say, ‘In the bosom of my family, with my friends around.’ They don’t say, ‘In a hospital bed with tubes coming out of my nose and my ears, in a semi-coma � that’s my perfect death.’”

Sigh. In fact, the number of hospital deaths is shrinking and the number of home deaths is growing–now, nearly 30%. Many die in nursing homes, it is true, but that is because many morbidly infirm elderly live in skilled nursing or assisted living facilities. But only about 20% of people die in ICUs, and often that is because of serious accidents, violent acts, or sudden illnesses, certainly not forced efforts to keep a dying person alive against their will.  

So, if we are going to have a “conversation” about death, and it is going to be reported in a major metropolitan newspaper, let’s at least get the facts straight.

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