{"id":55247,"date":"2013-12-31T10:00:56","date_gmt":"2013-12-31T15:00:56","guid":{"rendered":"http:\/\/thesocietypages.org\/socimages\/?p=55247"},"modified":"2013-12-30T23:48:44","modified_gmt":"2013-12-31T04:48:44","slug":"how-do-physicians-and-non-physicians-want-to-die","status":"publish","type":"post","link":"https:\/\/thesocietypages.org\/socimages\/2013\/12\/31\/how-do-physicians-and-non-physicians-want-to-die\/","title":{"rendered":"How Do Physicians and Non-Physicians Want to Die?"},"content":{"rendered":"

<\/em>We\u2019re celebrating the end of the year with our most popular posts from 2013, plus a few of our favorites tossed in. \u00a0Enjoy!<\/em><\/p>\n

A recent RadioLab<\/a> podcast, titled The Bitter End<\/a>, identified an interesting paradox. When you ask people how they’d like to die, most will say that they want to\u00a0die quickly, painlessly, and peacefully… preferably in their sleep.<\/p>\n

But, if you ask them whether they would want various types of interventions, were they on the cusp of death and already living a low-quality of life, they typically say “yes,” “yes,” and “can I have some more please.” \u00a0Blood transfusions, feeding tubes, invasive testing, chemotherapy, dialysis, ventilation, and chest pumping CPR. Most people say “yes.”<\/p>\n

But not physicians. \u00a0Doctors, it turns out, overwhelmingly say “no.” \u00a0The graph below shows the answers that physicians give when asked if they would want various interventions at the bitter end. \u00a0The only intervention that doctors overwhelmingly want is pain medication. \u00a0In no other case do even 20% of the physicians say “yes.”<\/p>\n

\"Screenshot_1\"<\/a><\/p>\n

What explains the difference between physician and non-physician responses to these types of questions. \u00a0USC professor and family medicine doctor Ken Murray gives us a couple clues.<\/p>\n

First, few non-physicians actually understand how terrible<\/em> undergoing these interventions can be. \u00a0He discusses ventilation. \u00a0When a patient is put on a breathing machine, he explains, their own breathing rhythm will clash with the forced rhythm of the machine, creating the feeling that they can’t breath. \u00a0So they will uncontrollably fight the machine. \u00a0The only way to keep someone on a\u00a0ventilator is to paralyze them. Literally. \u00a0They are fully conscious, but cannot move or communicate. \u00a0This is the kind of torture, Murray suggests, that we wouldn’t impose on a terrorist. \u00a0But that’s what it means to be put on a ventilator.<\/p>\n

A second reason why physicians and non-physicians may offer such different answers has to do with the perceived effectiveness<\/em> of these interventions. \u00a0Murray cites a study of medical dramas<\/a> from the 1990s (E.R., Chicago Hope, etc.) that showed that 75% of the time, when CPR was initiated, it worked. \u00a0It’d be reasonable for the TV watching public to think that CPR brought people back from death to healthy lives a majority of the time.<\/p>\n

In fact, CPR doesn’t work 75% of the time. \u00a0It works 8% of the time<\/a>. \u00a0That’s the percentage of people who are subjected to CPR and are revived and live at least one month. \u00a0And those 8% don’t necessarily go back to healthy<\/em> lives: 3% have good outcomes, 3% return but are in a near-vegetative state, and the other 2% are somewhere in between. \u00a0With those kinds of odds, you can see why physicians, who don’t have to rely on medical dramas for their information, might say “no.”<\/p>\n

The paradox, then — the fact that people want to be actively saved if they are near or at the moment of death, but also want to die peacefully — seems to be rooted in a pretty profound medical illiteracy. \u00a0Ignorance is bliss, it seems, at least until the moment of truth. Physicians, not at all ignorant to the fraught nature of intervention, know that a peaceful death is often a willing one.<\/p>\n

Cross-posted at\u00a0Pacific Standard<\/a>,\u00a0The Huffington Post<\/a>, and\u00a0BlogHer<\/a>.<\/em><\/p>\nLisa Wade, PhD<\/a> is an Associate Professor at Tulane University. She is the author of <\/em>American Hookup<\/a>, a book about college sexual culture; a textbook about gender<\/a>; and a forthcoming introductory text: <\/em>Terrible Magnificent Sociology<\/a>.\u00a0You can follow her on Twitter<\/a> and Instagram<\/a>.<\/em><\/span>","protected":false},"excerpt":{"rendered":"

We\u2019re celebrating the end of the year with our most popular posts from 2013, plus a few of our favorites tossed in. \u00a0Enjoy! A recent RadioLab podcast, titled The Bitter End, identified an interesting paradox. When you ask people how they’d like to die, most will say that they want to\u00a0die quickly, painlessly, and peacefully… […]<\/p>\n","protected":false},"author":51,"featured_media":55248,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[233,252,2104,693,290,76],"class_list":["post-55247","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-death","tag-healthmedicine","tag-knowledgeintelligence","tag-public-opinion","tag-sciencetechnology","tag-work"],"jetpack_featured_media_url":"https:\/\/thesocietypages.org\/socimages\/files\/2013\/05\/Screenshot_1.png","_links":{"self":[{"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/posts\/55247","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/users\/51"}],"replies":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/comments?post=55247"}],"version-history":[{"count":16,"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/posts\/55247\/revisions"}],"predecessor-version":[{"id":60870,"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/posts\/55247\/revisions\/60870"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/media\/55248"}],"wp:attachment":[{"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/media?parent=55247"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/categories?post=55247"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thesocietypages.org\/socimages\/wp-json\/wp\/v2\/tags?post=55247"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}