Two days after her magazine published Evan Thomas's "Case for Killing Granny" -- see related NewsBusters post here -- Newsweek staffer Jesse Ellison lamented that her "grandmother lived a full life and sought a quiet death" but "America's health-care system had a different idea of what was best."
In a September 14 Newsweek Web exclusive, Ellison laid out a story of zealous coverage aimed at prolonging her late grandmother's life, complaining that her grandmother's wish to die peacefully was disregarded as she was "treated like a problem to be solved, not as an elderly woman who had had enough."
Although Ellis's grandmother "had great insurance" plus "enough savings to pay for anything that Medicare and her insurance company would not," the writer found cause for complaint in the health care system having a bias to save and extend life, as well as the high costs that that approach incurred:
Because of the way her health improved, then so quickly declined, and because the system is set up to save people, not let them die, those last few weeks became needlessly tragic. They were also—and this really would have made my grandmother irate—enormously wasteful. Tens of thousands of dollars were spent on care and treatment: the ambulance trips alone averaged $500 apiece; the first visit to hospice cost more than $10,000; and the bill for three days in Lenox Hill came to $36,772.43, not including visits from doctors. All this for a 91-year-old woman with terminal cancer and no wish to hang on.
We tried, again and again, to push for the absolute minimum in treatment during those last weeks. I asked, again and again, for nurses to give her as much morphine as they could so that she might finally stop thrashing around on her bed. But it's hard to tell strangers whose job is to keep people alive that you actually want your loved one to just die already. And it's brutal to say it dozens of times, to dozens of strangers, who don't really seem to be listening anyway.
Silly medical health professionals and their desire to save life. It's almost as if they need a government panel to intervene to keep costs low and treatment minimal.
For her part, Ellis wasn't seeking to make a policy argument, just to relay her heartbreaking story of her grandmother's dying days. While one can sympathize with her heartbreaking true story, it's hard to ignore the implications of Newsweek publishing the story days after Evan Thomas essentially argued for greater use of end-of-life counseling:
Although demagogued as a "death panel," a program in Wisconsin to get patients to talk to their doctors about how they want to deal with death was actually a resounding success. A study by the Archives of Internal Medicine shows that such conversations between doctors and patients can decrease costs by about 35 percent—while improving the quality of life at the end. Patients should be encouraged to draft living wills to make their end-of-life desires known. Unfortunately, such paper can be useless if there is a family member at the bedside demanding heroic measures. "A lot of the time guilt is playing a role," says Dr. David Torchiana, a surgeon and CEO of the Massachusetts General Physicians Organization. Doctors can feel guilty, too—about overtreating patients. Torchiana recalls his unease over operating to treat a severe heart infection in a woman with two forms of metastatic cancer who was already comatose. The family insisted.
Studies show that about 70 percent of people want to die at home—but that about half die in hospitals. There has been an important increase in hospice or palliative care—keeping patients with incurable diseases as comfortable as possible while they live out the remainder of their lives. Hospice services are generally intended for the terminally ill in the last six months of life, but as a practical matter, many people receive hospice care for only a few weeks.
Our medical system does everything it can to encourage hope. And American health care has been near miraculous—the envy of the world—in its capacity to develop new lifesaving and life-enhancing treatments. But death can be delayed only so long, and sometimes the wait is grim and degrading. The hospice ideal recognized that for many people, quiet and dignity—and loving care and good painkillers—are really what's called for.
For her part, Ellis ended her story on a similar note:
We want to treat death with a kind of reverence—with awe and solemnity. But for many of us, the truth is that it's not deep, it's not rich, it's not meaningful. It's just ugly, especially when it's prolonged for no good reason. Who are we protecting in moments like these? Who are we helping? Who are we thinking of? Not me. Not my father. Certainly not my grandmother.