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Question: What are healthy ways of dealing with the dying process? 

Patricia Bloom: What has been true to too a great extent to conventional medicine—in this country, and I think in a lot of places—is that death is seen as the ultimate failure against which you fight with big guns all the way to the end. And we see that for a lot of people that’s not appropriate. I don't know what the experience was with the author's friend, but for many people, it becomes appropriate at a certain point that is most appropriately determined by that person themselves, or in conjunction with their loved ones and under the advisement of the medical profession when to make the transition away from the aggressive interventions and go more for quality of life, dignity, having a peaceful death. 

But I think a really important point is that that line is different for every person. There was just an article on the front page of The New York Times the other day about a patient who was at Mt. Sinai and was one of the patients of one of our palliative medicine doctors, and the patient herself was a palliative medicine doctor. That is what was so interesting. And she herself, although she had been involved in the field of helping people make that transition... she herself found that she had to fight, to keep fighting for herself. She continued to pursue aggressive therapy up pretty close to the end, and so the important point was that that was her individual decision. 

And so what some people might have taken away from the article was, "Well here was a palliative medicine doctor who wasn’t doing what she preached." That really wasn’t the message. It was the message that for every person, they should be empowered to make the right choices based on their personal preferences. But they should... I think it’s the role of people who are interested in seeing the experience of dying changed to a much, you know, better death. That’s a question: "Is there such a good thing as a good death?" And I think, yes, I have seen good deaths, and I think there can be much better deaths for a lot of people. So we have a long way to go, even relieving pain and suffering. We don’t do a good job of that. So, this woman’s friend, she may not have had adequate treatment of her pain. As the medical profession, we frequently fail in that regard. So, we really need to improve on people’s knowledge about and ability to relieve pain and that would change the face of dying as well. I think a lot of patients—and there’s great interest in assisted suicide, and that’s a whole big area of discussion. But it would probably be true that for a lot of patients who were interested in assisted suicide, maybe the point of that decision would change if they had better treatment. If they were more comfortable with the process that they were going through. 

Recorded on April 14, 2010

More from the Big Idea for Saturday, June 05 2010


How to Die Well

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