Skip to main content

Newsweek article on rethinking end of life care


The current issue of Newsweek includes an article titled "The Case for Killing Granny: Rethinking End of Life Care." It also seems to be titled "We Need to Talk About Death".

Although the headline seems a bit sensationalist (it certainly caught my eye, as I was trolling through a database of popular media articles on aging), the piece itself is thoughtful and a decent read. Unsurprisingly, it has also generated a lot of reader comments.

It will be interesting to see how this national conversation on end-of-life care evolves.

Comments

Alex Smith said…
The title is terrible. I agree that the article is thoughtful (mostly). I can see the editors sitting around thinking, "how can we get people to buy this issue - ah ha! killing grandma!" Killing grandma would be euthanasia, or just that, killing. No proposals discussed in congress, or in the article for that matter, make a case for euthanizing older adults. Having an inflammatory title like that will only re-enforce lies surrounding current health legislation, e.g. death panels.
ken covinsky said…
Not only is the title terrible, it is irresponsible and reprehensible. Newsweek has descended into gutter journalism with this title, and apparently the cover.

The meritorious part of the article is the description of the author's experience with his mother. It seems that as she was dying, she had to fight to have her wishes for compassionate palliative care honored. To essentially equate the honoring of her preferences with euthanasia is absurd. The troubling part of the story is not the cost of her ICU care, but the needless suffering that ensued from providing unwanted care that most likely did nothing to extend her life.

It strikes me that the whole discussion about rationing care at the end of life is misplaced. Yes, there are some patients who want "everything done", but this is a minority of patients. Can't we just start with learning how to have honest discussions with our patients about the probable outcomes of their care and their preferences? This would lead to elimination of much ineffective care, and suffering that results from unwanted and ineffective care. It may be the case, that substituting palliative care for highly invasive care will sometimes save money, but it is crucial that the motivation is doing the right thing for patient, not $s.
Ty Meyer said…
Sensational title to be sure, but I found the article to be interesting and for the most part well written. Will be passing it along at work.
Eric Widera said…
I agree with Ty. Magazine titles (or blog titles for that matter) are meant to be provocative so they draw in readers. Did Evan Thomas take it a little too far - yes. It's not about "killing granny" as her disease has taken care of that. It is about respecting her wishes, and this was nicely stated in meat of the article.

One question that comes to my mind though is if the means justifies the end (the title got me to read the article and talk about it - I'm pretty sure I wouldn't have if it were not for this title). I'm sure that Sarah Palin and Chuck Grassley don't really believe that "death panels" would exist with a public plan, but their strategy worked because it was provocative. Should the other side stoop so low?
elderlaw said…
Eh, I think the title is clearly tongue-in-cheek, maybe even making fun of the senationalist fearmongers who thought up the unplug granny scenario in the first place. That said, one of the sad results of the false debate over the nonexistent death panels is that we may no longer effectively deal with the practicalities of the issue; we can't discuss the economics of end-of-life overcare without looking like the ghouls that the Republicans say we are.

Popular posts from this blog

Dying without Dialysis

There is a terrific article in this weeks Journal of Pain and Symptom Management by Fliss Murtagh of King's College in London about the epidemiology of symptoms for patients with advanced renal failure who die without dialysis.  This study is important because while we know that patients with advanced renal failure have a limited life expectancy and the average age of initiation of hemodialysis is increasing, we know little about the alternatives to hemodialysis.  Specifically, we know nothing about symptoms affecting quality of life among patients who elect not to start dialysis (so called "conservative management" - is this the best label?).  This article provides a terrific counterpoint to the article in last years NEJM showing that nursing home residents who initiated hemodialysis tended to die and decline in function (see GeriPal write up here). 

The study authors followed patients with the most advanced form of chronic kidney disease (the new name for renal failu…

Language Matters: Podcast with Brian Block and Anna DeForest

One of our first GeriPal posts was titled "Rant on Terminology," by Patrice Villars, NP.  In the spirit of looking back over our first 10 years, here is the opening paragraph to that post:

News Headlines read: Sen. Edward Kennedy loses battle with cancer. Really, he lost? I thought he died from a malignant brain tumor, an “aggressive” brain tumor. The median survival is less than a year for people for his particular tumor. Kennedy was diagnosed in May of 2008. He lived over 15 months after diagnosis. What a loser. He must not have fought hard enough. Huh? I thought he spent most of his life battling for social and health care reform in America. In this week's GeriPal podcast we take a deeper dive into this issue of language and medicine.  We are joined by guests Anna DeForest, MD, MFA, a resident in Neurology at Yale, and Brian Block, MD, a pulmonary critical care fellow at UCSF.  

Anna recently published a paper in the NEJM describing her reaction to hearing terms like, &…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …