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How do we die?

Published online by Cambridge University Press:  08 September 2016

Bonnie Stabile  and
Aubrey Grant
Bonnie Stabile*
Affiliation:
Schar School of Policy and Government, George Mason University
Aubrey Grant
Affiliation:
Schar School of Policy and Government, George Mason University
*
Correspondence: Bonnie Stabile, Schar School of Policy and Government, George Mason University, 3351 Fairfax Drive, MS3B1, Arlington, VA 22201. Email: [email protected]
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Abstract

Within the next two decades, the elderly population in the United States will reach its zenith, comprising 73 million individuals, 20 percent of the nation, the baby boomers’ final surge. The process of their dying may become contentious. Should policymakers and bioethicists be satisfied with our current approach to dying, or should they begin now to reconceptualize it? We distill end-of-life discussions in the bioethics literature and popular press, paying particular attention to physician-assisted suicide and its uptake where legal. Evidence so far indicates that few of the dying opt for this alternative, suggesting that its role in assuring “death with dignity” cannot be, as may have been hoped, a leading one. The end-of-life literature on the whole lends credence to the fear that most of the dying, along with their families and physicians, will muddle through a morass of uncoordinated options, with futile medical intervention the most prominent outcome — despite more palliative strategies, such as home hospice care, being favorably described. We found no reason to recommend persistence in our current approach to dying and found good reason to urge early, conscientious, and thoroughgoing reconceptualization in policy and practice as well as in theory.

Keywords

Assisted suicidehospicepalliative caredeath with dignityend-of-life care
Type
Perspective
Information
Politics and the Life Sciences , Volume 35 , Issue 2 , Fall 2016 , pp. 69 - 74
Copyright
© Association for Politics and the Life Sciences 2016 

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References

McLellan, Dennis, “Dr. Kevorkian dies at 83: ‘Dr. Death’ was advocate, practitioner of physician-assisted suicide,” Los Angeles Times, June 4, 2011, http://articles.latimes.com/2011/jun/04/local/la-me-jack-kevorkian-20110604, accessed June 10, 2016.Google Scholar
Roig-Franzia, Manuel, “Long legal battle over as Schiavo dies: Florida case expected to factor into laws for end-of-life rights,” Washington Post, April 1, 2005,http://www.washingtonpost.com/wp-dyn/articles/A15423-2005Mar31.html, accessed June 10, 2016.Google Scholar
Grossman, Cathy Lynn, “Calif. end-of-life law, inspired by Brittany Maynard, to go into effect,” USA Today, June 8, 2016, http://www.usatoday.com/story/news/2016/06/08/california-end-of-life-brittany-maynard/85598064, accessed June 10, 2016.Google Scholar
Hardwig, John, “Going to meet death,” Hastings Center Report , 2009, 39(4): 37–45, doi:10.1353/hcr.0.0151.CrossRefGoogle ScholarPubMed
Gillick, Muriel R., “Shades of gray,” Hastings Center Report , 2009, 39(2): 46–47, doi:10.1353/hcr.0.0118.Google Scholar
Ortman, Jennifer M., Velkoff, Viktoria A., and Hogan, Howard, “U.S. Census Bureau, “An aging nation: The older population in the United States,” Current Population Reports, May 2014, https://www.census.gov/prod/2014pubs/p25-1140.pdf, accessed July 11, 2016.Google Scholar
Yang, Y. Tony and Curlin, Farr A., “Why physicians should oppose assisted suicide,” JAMA , 2016, 315(3): 247–248.Google Scholar
Onwuteaka-Philipsen, Bregje D., Brinkman-Stoppelenburg, Arianne, Penning, Corrine, deJong-Krul, Gwen J. F., van Delden, Johannes J. M., and van der Heide, Agnes, “Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: A repeated cross-sectional survey,” Lancet , 2012, 380(9845): 908–915.Google Scholar
Quill, Timothy E., “Physicians should ‘assist in suicide’ when it is appropriate,” Journal of Law, Medicine, and Ethics , 2012, 40(1): 57–65.Google Scholar
Yardley, William, Report finds 36 died under assisted suicide law,” New York Times, March 4, 2010, http://www.nytimes.com/2010/03/05/us/05suicide.html.Google Scholar
Dugan, Andrew, “In U.S., support up for doctor-assisted suicide,” Gallup, May 27, 2015, http://www.gallup.com/poll/183425/support-doctor-assisted-suicide.aspx, accessed July 11, 2016.Google Scholar
Oregon Public Health Division, “Oregon’s Death with Dignity Act — 2014,” https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf, accessed July 11, 2016.Google Scholar
Associated Press, “Oregon reports 127 heroin deaths in 2009,” Daily News Online, April 5, 2010, http://tdn.com/news/article_80f5368a-40c0-11df-98cd-001cc4c03286.html, accessed July 11, 2016.Google Scholar
Oregon Health Authority, “Oregon Death With Dignity Act: 2015 Data Summary,” February 4, 2016, https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year18.pdf, accessed June 10, 2016.Google Scholar
Oregon Public Health Division, “Oregon Death with Dignity Act: 2015 Summary Data,” https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ar-index.aspx, accessed July 15, 2016.Google Scholar
Washington State Department of Health, “2015 Death with Dignity Act Report,” http://www.doh.wa.gov/portals/1/Documents/Pubs/422-109-DeathWithDignityAct2015.pdf, accessed July 15, 2016.Google Scholar
Lindblom, Charles E., “The science of ‘muddling through’,” Public Administration Review , 1959, 19(2): 79–88.Google Scholar
Gawande, Atul, “What should medicine do when it can’t save you?” New Yorker, August 2, 2010, http://www.newyorker.com/magazine/2010/08/02/letting-go-2, accessed July 11, 2016.Google Scholar
Wolf, Susan M., “Confronting physician-assisted suicide and euthanasia: My father’s death,” Hastings Center Report , 2008, 38(5): 23–26.Google Scholar
Butler, Katy, “What broke my father’s heart,” New York Times Magazine, June 14, 2010, http://www.nytimes.com/2010/06/20/magazine/20pacemaker-t.html, accessed July 11, 2016.Google Scholar
Sullivan, Amy M., Lakoma, Matthew D., and Block, Susan D., “The status of medical education in end-of-life care: A national report,” Journal of General Internal Medicine , 2003, 18(9): 685–695.CrossRefGoogle ScholarPubMed
Thomas, Roby A., Curley, Brendan, Wen, Sijin, Zhang, Jianjun, Abraham, Jame, and Moss, Alvin H., “Palliative care training during fellowship: A national survey of U.S. hematology and oncology fellow,” Journal of Palliative Medicine , 2015, 13: 747–751.Google Scholar
Gibbins, Jane, McCoubrie, Rachel, and Forbes, Karen, “Why are newly qualified doctors unprepared to care for patients at the end of life? ” Medical Education , 2011, 45: 389–399.Google Scholar
Thomas, John M., O’Leary, John R., and Fried, Terri R., “A comparison of the willingness of resident and attending physicians to comply with the requests of patients at the end of life,” Journal of General Internal Medicine , 2014, 29(7): 1048–1054.CrossRefGoogle ScholarPubMed
Lantos, John D., “Just visiting,” Hastings Center Report , 2004, 34(3): 6–7.Google Scholar
Burt, Robert A., “Lessons from Susan Sontag’s Death,” Hastings Center Report , 2009, 39(2): 38–45.Google Scholar
Associated Press, “Americans are treated, and overtreated, to death,” NY Daily News, June 28, 2010,http://www.nydailynews.com/life-style/health/americans-treated-overtreated-death-article-1.184998, accessed July 11, 2016.Google Scholar
Severo, Richard, “Obituary: Art Buchwald, columnist who delighted in the absurd — Americas — International Herald Tribune,” New York Times, January 18. 2007, http://www.nytimes.com/2007/01/18/world/americas/18iht-web.0118buchwaldcnd.4252394.html, accessed July 11, 2016.Google Scholar
Burt, Robert A., ““The end of autonomy,” Improving End of Life Care: Why Has It Been So Difficult? ” Hastings Center Report Special Report , 2005, 35(6): S9–S13.Google Scholar
Periyakoil, Vyjeyanthi S., Noda, Arthur M., and Kraemer., Helena Chmura, “Assessment of factors influencing preservation of dignity at life’s end: Creation and the cross-cultural validation of the preservation of dignity card-sort tool,” Journal of Palliative Medicine , 2010, 13(5): 495–500.Google Scholar
Cook, Deborah and Rocker, Graeme, “Dying with dignity in the intensive care unit,” New England Journal of Medicine , 2014, 370(26): 2506–2514.Google Scholar
Balducci, L., “Death and dying: What the patient wants,” Annals of Oncology , 2012, 23(Suppl 3): 56–61.Google Scholar
Byock, Ira, “Dying with dignity,” Hastings Center Report , 2010, 40(2): 3.Google Scholar
Stanley, John M., “What the people would want if they knew more about it: A case for the social marketing of hospice care,” Hastings Center Report Special Supplement , 2003, 33(2): S22–S23.Google Scholar
National Hospice and Palliative Care Organization, “History of Hospice Care,” 2016, http://www.nhpco.org/history-hospice-care, accessed June 10, 2016.Google Scholar
National Hospice and Palliative Care Organization. “NHPCO’s Facts and Figures: Hospice Care in America,” 2015, http://www.nhpco.org/sites/default/files/public/Statistics_Research/2015_Facts_Figures.pdf, accessed June 10, 2016.Google Scholar