SEPT. 25, 2000

National Notes
Fighting for the Dying: It's Not a Losing Battle

According to a recent feature in Time Magazine, "7 out of 10 Americans say they want to die at home; instead, three-fourths die in medical institutions." While 95% of pain experienced by terminally ill patients can be mollified, "studies show that nearly half of Americans die in pain, surrounded and treated by strangers." Technology can extend the length of life, but not always the quality of life. And unfortunately, American society tends to think of death as a defeat rather than an unavoidable process. This way of thinking, among many other obstacles, often keeps individuals, healthcare providers, and caregivers from taking steps to ensure a more comfortable death.
For instance, most doctors lack training in managing pain because medical schools are just beginning to offer such curriculums. Many doctors also "flinch at using controlled substances because of the nation’s harsh antidrug laws." Fearing legal scrutiny, some physicians will choose a medication that is weak or ineffective against the patient’s pain.

And many people fail or refuse to communicate about death. Even those who plan for death often don’t tell their loved ones what those plans are. A recent study revealed that 30% of Americans who have been designated as healthcare surrogates for family members or friends don’t even know they’ve been designated.

But a group of reform-minded physicians, caregivers, and academics hope to remove these and other hindrances to better end-of-life care. The Time feature—along with the recent PBS special "On Our Own Terms" and various other publications—is part of an effort to raise awareness of the issues of death. For more information on these issues, including the benefits of hospice care, visit www.abcd-caring.org, a comprehensive and authoritative site provided by Americans for Better Care of the Dying.