Have We Changed Our Attitudes About Death?

As a health and medicine reporter, I have written a lot of end-of-life stories—about the development of the hospice movement; current medical philosophy and practices; legal fights of the right-to-die and death-with-dignity crowd; and people who were dying. I think I remained neutral about this hot-button issue and presented both sides—which wasn’t easy because I don’t believe in maintaining life regardless of quality.

I do recognize the right to hang on no matter what it takes, but it is not the right of families to maintain a life when patients have previously expressed otherwise but can’t voice that wish.

Maybe my opinion has been shaped by an experience I had early in my nursing career.

I was a new graduate and was caring for a man who was not yet 40 and comatose from kidney failure. This was before kidney dialysis, so he was receiving peritoneal dialysis in his hospital room. Even this procedure was somewhat new at the time. His wife was constantly at his bedside and their two young children visited in the evening with the grandparents.

What made it even sadder was the fact that the nephrologist continued to tell the family that there was hope of recovery, but lab tests day after day continued to say otherwise. In the meantime, we continued to give the man endless drug injections (no PICC lines then) and blood draws for labs—and wondered how much he might be suffering.

I was greatly troubled about this and began dreading coming to work. I finally asked the doctor why we were still treating the man so vigorously when his condition did not improve. The doctor exploded. It was soon clear that this patient’s failure to recover somehow was an affront to his skills and ego.

The attitude about death in the 1960s, especially if the patient was young, was that it wasn’t allowed to happen. If a patient died, it was because the doctor failed and patients had little say about how they were treated or whether they chose to die.

Thank goodness that much has changed in the ensuing four decades. But when confronted with a hopeless case—either professionally or personally—are you ready to respect the patient’s decision?

Can you actively support it if don’t agree?

Do you think the attitude about death in this country has changed for better or worse?