People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives.
The usual brilliance from Dr. Gawande. This one, though, is emotionally powerful. It’s amazing, really, how unwilling American medicine is to talk about end-of-life care. The comforting story, as he presents, is how fruitful and positive hospice can be.