Steve teaches a class about public health and aging for people getting a certificate in public health. Most of the students are healthcare professionals, but unfortunately, not doctors. They should be taking the class. Today’s class was a discussion based on an article about limiting medical interventions for older patients (late 70’s and up). Steve invited me to come to the class and sent me the reading. While the argument generates lots of controversy it presupposes so many things that won’t come to pass in my lifetime, it becomes meaningless.
Simplifying the argument: In a more perfect world, where elders are respected and not the subject of so much prejudice, it should be possible to make a rule based on age, limiting what medicare would pay for in the way of technological interventions. When the class began I was the only one in favor of the argument. After a spirited discussion we concluded it would be best if medical decisions were made based on the individual and on science, whatever that means. Since I haven’t met too many doctors who look at the whole person and who don’t base their decisions on things like worry about malpractice suits, pharmaceutical company propaganda and the need to avoid death regardless of the patient’s wishes, I rather like the idea of a rule or concensus based on age. I don’t want to die hooked up to machines, like my mother. Nor do I want round the clock caretakers and being treated like a child. These seem to be today’s inevitabilities.
One of the biggest problems is no one wants to talk about death. We seem to think it will go away if we ignore it, or maybe, if we can just keep breathing, they’ll find some way to keep us alive forever. Instead, it creeps up on us and takes us in the most terrible, painful, undignified ways. It would help if we had a good, rational discussion about how we want doctors to treat us and how we want to die. We aren’t going to live forever; wishful thinking won’t make it so.