By Dave Andrusko
When you come across anything about “death and dying,” you really have to read with exceptional care. The conclusions researchers/reporters draw often are much more their own personal preferences than they are what the data are saying.
Here’s an example: “Most people want to live past 75, but they haven’t given much thought to dying,” written by the Washington Post’s Jason Millman.
He is making his case based on two recent developments: “the influential Institute of Medicine issued a 507-page report recommending major reforms for how end-of-life care is provided”; and bioethicist Ezekiel Emanuel’s essay where he tells us “Why I Hope to Die at 75: An argument that society and families—and you—will be better off if nature takes its course swiftly and promptly.” (By the way it’s very important to the rest of us because Emanuel, a powerful figure, is a big believer in rationing health care.)
I have not read the former. Fortunately another staff member, far more knowledgeable than I am about the end-of-life debate, has. I have read the latter, which Millman talks about most. [In a nutshell, Emanuel concludes, “By the time I reach 75, I will have lived a complete life.”]
So where does Millman take this notion that Emanuel doesn’t want to live past 75?
For starters, that desire
“solidly puts him in the minority of Americans, according to an August 2013 Pew Research Center poll. Just 14 percent said their ideal life span is 78 or younger, with the strongest support for this view coming from the youngest grouping of adults — ‘to whom old age may seem far away,’ as Pew described the finding.”
Then we have to start reading extra careful:
“About two-thirds of Americans agree that there are legitimate reasons why a patient should be allowed to die, according to another Pew poll released last November.”
Of course how you pose the question is absolutely critical. What were the choices Pew gave respondents?
“There are circumstances in which a patient should be allowed to die.”
“Medical staff should do everything possible to save patients’ life in all circumstances.”
The 66% who chose the former is surprisingly only in that you would have suspected the percentage to be even higher. Talk about stacking the deck. The former is not about the “right to die” let alone “assisted suicide.” It sounds benign. The latter could be interpreted as staff compelling a patient to receive unwanted treatment.
Click here to read the September issue of
National Right to Life News,
the “pro-life newspaper of record.”
But that 31% could also mean something entirely different.
Millman next says:
“Meanwhile, a minority (31 percent) said medical professionals should do everything possible to keep patients alive, which is up 16 percentage points since Pew first polled on this topic in 1990. Pew said the increase is the result of more people removing themselves from the undecided category. Older adults, though, are more likely to say patients have a right to die.”
In other words, almost twice as many people now want staff to do everything they can to save patients’ lives in all circumstances as did in 1990. Perhaps this is a signal that the word is getting out–too many physicians are subscribers to the “quality of life” ethic. And that it is only proper for patients to be able to expect medical staff to do everything they can to save their life, not make “quality” judgments.
We will report on the Institute of Medicine’s “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life” next week. Suffice it to say that just glancing at the introduction and the summary of the key findings and recommendation makes me very nervous.