Sunday, 29 July 2012

How doctors choose to die

Modern medicine almost refuses to let a patient die. Elaborate operations are performed on him, he  is connected to all kinds of machines which do the job of failed organs, tubes are inserted into him  to feed, to give blood and to remove wastes, and newer and evermore potent medicines are poured into him to keep him alive. Most specialist doctors who deal with terminally ill patients prescribe these interventions and drugs. But do these expert doctors want the same life-prolonging treatment when they themselves are terminally ill?  
A recent article "How Doctors Choose To Die" written by Dr. Ken Murray, a professor of medicine at the University of Southern California, published first in and then reprinted in many newspapers worldwide gives the surprising answer "No" to this question. Doctors across the US and UK have responded to his provocative article and most seem to agree with him that the best death is the least medicated. They generally feel that the quality of life is more important than the quantity. But they seem to be uncomfortable with the dichotomy in their thinking.  
Dr. Murray poses the interesting question "How has it come to this, that doctors administer so much care that they wouldn't want for themselves?" and answers it by holding the patients, the doctors and the system responsible, the patients because they expect too much from medical science, the doctors because they fail to present only reasonable options to the patient or his family, and the system because it threatens doctors for doing too little and never for doing too much.  
The stress of facing constantly the dichotomy of administering expensive medical care which is ultimately futile and which makes people suffer and being against such treatment if they themselves were the patients is, according to Dr. Murray, one of the reasons why physicians have higher rates of alcohol abuse and depression than professionals in most other fields.
B.V. Shenoy, Mysore Grahakara Parishat