Speaking of Life Spans

Oddly, this week seems to have been a big one for research studies on end-of-life care.

First up, a study done at the University of Pennsylvania that compared end-of-life care in Belgium, Canada, England, Germany, the Netherlands, Norway and the U.S. Long story short, we're about average in terms of what we spend caring for people in the last six months of life, and similarly average in the percent of people who die in the hospital.

That said, it seems we try to do more for to for/to dying patients in the U.S. than in the other countries studied. For example, and of particular interest to me, over 40 percent of patients who die with cancer in the U.S. are admitted to the intensive care unit (ICU) in the last six months of life, more than twice the amount of any other country studied. We also do more pointless chemo: 39 percent of American patients dying with cancer received at least one chemotherapy treatment in the last six months of life, again more than any other country in the study. 

Since we're on the subject and just for the record, if I die in the hospital you can be completely and entirely assured that things did not go in accordance with my wishes. I want to die in my condominium, smiling as I think about the poor people who are going to have to figure out how to drag my 6'5" body down my very narrow stairs with the pictures on one side, the periodic table paintings on the other, and the 90 degree turn two-thirds of the way down. Best case scenario: they'll get me wedged into the corner, like that couch in the Google ad. It's probably just me, but I think that would be an absolute riot. 

Anyway, back to our research studies...

In addition to the end-of-life comparison study above, the Journal of the American Medical Association today published two more of my very favorite type of medical study: the comparison of medical choices normal people make to those doctors make. 

You will likely not be surprised to hear that doctors were once again found to be less likely than the general populace to be admitted to the ICU, less likely to die in a medical facility, and less likely to receive surgery in the period before their death. Doctors have experienced the reality of medical care while the rest of us see medicine on ER, House or Grey's Anatomy. Is it any wonder they make different choices than we do?

As one medical professional told ABC in response to the studies, "In many cases, we're not saving lives -- we're prolonging dying."

Oh yeah, sign me up for that. Make something intrinsically lousy be even lousier and last even longer.

I think not.