From theWASHINGTON POST:
…For most of us living with sidewalks and street lamps, death has become a rarely witnessed, foreign event. The most up-close death my urban-raised children have experienced is the occasional walleye being reeled toward doom on a family fishing trip or a neighborhood squirrel sentenced to death-by-Firestone. The chicken most people eat comes in plastic wrap, not at the end of a swinging cleaver. The farmers I take care of aren’t in any more of a hurry to die than my city-dwelling patients, but when death comes, they are familiar with it. They’ve seen it, smelled it, had it under their fingernails. A dying cow is not the same as a person nearing death, but living off the land strengthens one’s understanding that all living things eventually die….
With unrealistic expectations of our ability to prolong life, with death as an unfamiliar and unnatural event, and without a realistic, tactile sense of how much a worn-out elderly patient is suffering, it’s easy for patients and families to keep insisting on more tests, more medications, more procedures…
When families talk about letting their loved ones die “naturally,” they often mean “in their sleep” — not from a treatable illness such as a stroke, cancer or an infection. Choosing to let a loved one pass away by not treating an illness feels too complicit; conversely, choosing treatment that will push a patient into further suffering somehow feels like taking care of him. While it’s easy to empathize with these family members’ wishes, what they don’t appreciate is that very few elderly patients are lucky enough to die in their sleep. Almost everyone dies of something…
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