How Doctors Choose To Die

When Einstein was dying, he refused surgery and said: “I want to go when I want. It is tasteless to prolong life artificially. I have done my share, it is time to go. I will do it elegantly.”

Doctors could have saved him by putting a stent in his heart, but Einstein denied, as he wanted to die a natural death.

Advance Decisions

If you are 18 or older you have the option of making what is known as an advance decision. You can refuse particular medical treatments for a time in the future when you may be unable to make such a decision. You can refuse a treatment that could potentially keep you alive such as ventilation and cardiopulmonary resuscitation (CPR).

Deciding To Refuse Treatment

“It’s not a frequent topic of discussion, but many doctors don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

Of course, doctors don’t want to die, they want to live. But they know enough about modern medicine to know its limits. They know enough about death to know what people fear most: dying in pain and dying alone.” – Ken Murray, a retired Los Angeles family doctor, in an article entitled ‘How Doctors Die (It’s Not Like the Rest of Us, But It Should Be)’

The article by Ken Murray discusses a patient called Charlie, a highly respected orthopedist, who was diagnosed with pancreatic cancer. He was told by the surgeon who treated him about a new technique for this exact cancer that could triple his five-year-survival odds – from 5% to 15% – but in return for a poorer quality of life. He decided to go home instead and spend time with his family. He died at home without returning to the hospital. He received no medical treatment.

Medical Progression

This article touches on an in-depth question around the quality of life. Often due to medical progression, it’s easier than before to sustain life. However, are we victims of a larger system that encourages excessive treatment? How about people who don’t want to be placed on life support machines.

‘’Jack, a 78-year-old who had been ill for years and undergone about 15 major surgical procedures. Jack suffered a massive stroke and was admitted to A&E unconscious, without his wife. Doctors did everything possible to resuscitate him and put him on life support. This was Jack’s worst nightmare. When I arrived at the hospital and took over Jack’s care, I spoke to his wife and to hospital staff, bringing in my office notes with his care preferences. Then I turned off the life support machines and sat with him. He died two hours later. Even with all his wishes documented, Jack hadn’t died as he’d hoped. The system had intervened.’’- ‘An American doctor explains why the best death can be the least medicated – and the art of dying peacefully, at home’ – The Guardian

Talking About Death As An Act Of Love

It’s important to discuss your last wishes. Letting your family know how you want to die makes it easier for them to decide whether this is ” right” or “wrong decision.”

Note: You can refuse a treatment that could potentially keep you alive, known as life-sustaining treatment (life-sustaining treatment is sometimes called life-saving treatment)

Remember: If you decide to refuse life-sustaining treatment in the future, your advance decision needs to be:

written down
signed by you
signed by a witness

Talking about death and dying it’s not the most pleasant subject but it’s necessary. It’s crucial to discuss this while we have our mental and physical faculties. It will make things easier for both the dying and the living when ‘the time comes’.

Where To Start

You can start by asking questions such as:

Would you want a feeding tube?
Do you want to breathe on a ventilator for a long period of time?
CPR and a ‘do not attempt CPR’ decision?
Injections of medicine?
Where would you like to be cared for, your home, a care home, or hospice?
Consider the circumstances under which you would not want to receive the specified treatment.
Explain your religious or other beliefs and values.
Think about Lasting Power of Attorney for Health and Care

Find out more details here: ‘Power Of Attorney – How To Get Started’

The advance decision allows you to express your desire to refuse medical treatment in the future. It’s referred to as a living will. Whatever you decide you should certainly consider discussing your advance decision with a healthcare professional who knows your medical history, your family, and friends so that they are aware of your wishes.

Note: The charity Compassion in Dying has an advance decision form you can fill in online.