The Downsides of Dying in a Hospital

Question: What are the downsides of dying in a hospital?

 

Ira Byock: Well, the medical model that, I began to talk about this problem-based model is really restricted, it’s very powerful and it helps us, but it only takes us so far. The fundamental nature of dying is not medical, it’s personal. And so dying cannot be encompassed by a set of medical problems, and a set of diagnosis and treatments. So while we can remain disease focused for as long as it makes sense, we also have to attend to the personal aspects of dying. People, you lose and dying in the hospital many times is you lose that personal time. Your space is not your own, people walk in and out, you don’t have this privacy or intimacy with family.

Beyond that though we – staying within that medical model, everybody who walks in your room or interacts with you or talking to you about medical problems, they will continue to conscript your attentions to the lab test and the scans and the next treatments and the drugs and your vital signs and all of that, instead of attending to the personal.

They actually conscript your time and energy for the medical. The best end of life care that I know of through modeled by hospice programs and the best palliative care programs still does all the medical stuff, but its subordinated to the personal, its – in hospice care we make appointments to see you and your family not the other way around, we’re coming to your home, we are explicitly acknowledging the importance of interactions of your privacy and intimacy.

And beyond that we’re even offering some help, some guidance that maybe of value to you in this area of human interaction, I would call life completion and life closure, which again in a problem-based medical model doesn’t even exist, it’s not there. Quality of life and quality of life completion really exists in a developmental model that really honors the breadth of human life for the person and family but not in a problem-based model. So even the very best of problem-based medicine, and including attention to symptoms and the like, tends not to see those personal experiences of completing one’s affairs, physical and legal and project-related affairs but also they are personal affairs, they are relationships, they are explorations of their own meaning and significance of their own life. Their relationship to something larger than themselves, that stuff that’s not abstract for people who know that, that their life is measured in weeks or days, it’s very tangible.

 

Recorded on: March 21, 2008

 

The downsides of dying in a hospital.

How to make a black hole

Here's the science of black holes, from supermassive monsters to ones the size of ping-pong balls.

Videos
  • There's more than one way to make a black hole, says NASA's Michelle Thaller. They're not always formed from dead stars. For example, there are teeny tiny black holes all around us, the result of high-energy cosmic rays slamming into our atmosphere with enough force to cram matter together so densely that no light can escape.
  • CERN is trying to create artificial black holes right now, but don't worry, it's not dangerous. Scientists there are attempting to smash two particles together with such intensity that it creates a black hole that would live for just a millionth of a second.
  • Thaller uses a brilliant analogy involving a rubber sheet, a marble, and an elephant to explain why different black holes have varying densities. Watch and learn!
  • Bonus fact: If the Earth became a black hole, it would be crushed to the size of a ping-pong ball.

Russian reporters discover 101 'tortured' whales jammed in offshore pens

Protected animals are feared to be headed for the black market.

(VL.ru)
Politics & Current Affairs
  • Russian news network discovers 101 black-market whales.
  • Orcas and belugas are seen crammed into tiny pens.
  • Marine parks continue to create a high-price demand for illegal captures.
Keep reading Show less

China’s artificial sun reaches fusion temperature: 100 million degrees

In a breakthrough for nuclear fusion research, scientists at China's Experimental Advanced Superconducting Tokamak (EAST) reactor have produced temperatures necessary for nuclear fusion on Earth.

Credit: EAST Team
Surprising Science
  • The EAST reactor was able to heat hydrogen to temperatures exceeding 100 million degrees Celsius.
  • Nuclear fusion could someday provide the planet with a virtually limitless supply of clean energy.
  • Still, scientists have many other obstacles to pass before fusion technology becomes a viable energy source.
Keep reading Show less