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A thought-provoking hour about how Americans spend their last days

BOOSTER SHOTS BLOG: Oddities, musings and news from
the health world

November 24, 2010|By Karen Kaplan, Los Angeles Times

For those who may have missed it (and that’s probably most of you), Booster Shots would like to endorse Tuesday night’s episode of Frontline, the documentary series on PBS stations.

In “Facing Death: How far would you go to sustain the life of someone you love, or your own?” the Frontline team explores the thorny questions surrounding medical care at the end of life. Should patients be offered invasive, uncomfortable and expensive treatments even when they have little chance of working and may reduce both quality and quantity of life? How can patients avoid spending so many fruitless months in costly ICU rooms at the end of their lives? What should doctors be doing differently to facilitate better conversations with their patients about how they’d like to spend their final days?

The episode offers some surprising answers from doctors at Mount Sinai Hospital in New York City, the terminally ill patients they treat, and the patients’ families. Among them is Debbie Moloney, whose husband John has had two bone marrow transplants to treat his multiple myeloma, a cancer of plasma cells in the bone marrow. After spending nearly nine months in the hospital, Debbie just wants John to be able to go home and share his remaining time with her. But John can’t seem to bring himself to get a “Do Not Resuscitate” order and give up hope that a long-shot treatment will make him well.

One of the doctors featured in the episode is Dr. David Nierman, the hospital’s chief medical officer. He laments that while advances in treating critically ill patients have allowed more people to get better, it has also created a new – and fast-growing – category of patients that he calls “chronically critically ill.” Here’s how he puts it on the Frontline website:

“The best thing clearly is to improve quickly and to leave. Although terrible, the second best thing is to die but to die quickly. But the worst thing is to remain in this state of suspended animation, because that can go on for months to years. And what's so sad about it is that the better we get at practicing critical care, the more of these patients we are creating.”

You can watch the entire episode online here.

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