Brittany Maynard’s Date With Death
Posted on Sunday, October 19th, 2014 at 7:40 pm by lifemediamatters
On Nov. 1, a 29-year-old woman named Brittany Maynard plans to end her own life. Diagnosed this year with stage four brain cancer, doctors told her that she would die — quite possibly with a great deal of pain and loss of body and cognitive function — within six months (The Los Angeles Times).
The Danger Of Assisted Suicide Laws
Posted on Sunday, October 19th, 2014 at 7:36 pm by lifemediamatters
My heart goes out to Brittany Maynard, who is dying of brain cancer and who wrote last week about her desire for what is often referred to as “death with dignity.”
Yet while I have every sympathy for her situation, it is important to remember that for every case such as this, there are hundreds — or thousands — more people who could be significantly harmed if assisted suicide is legal (CNN).
Making The Best Of The End of Life
Posted on Sunday, October 19th, 2014 at 7:13 pm by lifemediamatters
I lost my mother to leukemia in 2011, and the last few months of her life were a true nightmare — for her and for us — not because her pain was worse than it had been or because the treatments were more excruciating, but because her doctors failed to provide even the most basic palliative care (The New York Times).
Death Class: New Jersey Offering Becomes A Chicago Idea?
Posted on Sunday, October 19th, 2014 at 3:26 pm by lifemediamatters
Another Chicago Ideas Week is drawing to a close, the annual fall celebration convening the brightest thought leaders worldwide to inspire and stimulate Chicagoans to act on new initiatives and ventures. Whether residents or institutions of higher education will act on one such proposal hinges on one key attribute: comfort with the concept of “death,” or the curiosity to learn more about it.
Dr. Norma Bowe, a tenured professor at Kean University’s College of Education, challenged educators and students to explore the possibility of a class like her own in Union, New Jersey; “Death in Perspective” is an experiential learning opportunity with a three year waiting list to enroll.
“It’s a framework to experience death as a reality instead of as a concept,” Bowe told a crowded Thorne Auditorium on the downtown campus of Northwestern University. The former nurse shuns a typical curriculum of many “Death and Dying” university classes that focus on philosophical, religious and historical aspects of the dying process and its meaning. Instead, 30 students each semester take weekly field trips.
Bowe tours undergraduates through hospitals, a Ronald McDonald House for families with children receiving treatment for serious illness, nursing homes, hospices, maximum security penitentiaries, funeral homes, crematories, cemeteries and the office of a medical examiner. There, students witness the process of an autopsy. Each week, students write a reflection on the places they tour.
The first assignment, however, is to write a letter to someone they love who has died; they then read their letters aloud to classmates. “There’s something very powerful about looking into a person’s eyes and sharing their grief together,” Bowe said.
She recounted the personal impact of her class on students; one student, who was suicidal, was befriended by another young woman who overcame suicidal tendencies. She sat next to the suicidal student each week, sharing how she came out of profound depression. Another student, after witnessing a woman hold her father’s hand and say goodbye to him as he died in hospice, decided to call her own father. “She hadn’t spoken with her father in four years,” Bowe said. “The light is always juxtaposed to the darkness.”
“It’s a framework to experience death as a reality instead of as a concept”
Class feedback keeps other students eager to enroll, Bowe said, sharing their comments: “Death doesn’t need to be scary, it’s a natural part of life,” “Bucket lists are important, do one,” and “Say things now rather than later to those you love.”
Bowe said her aim is broader than to foster an understanding of death, but to encourage authenticity, openness, sharing, honesty, fearlessness and acceptance.
“Life is a precious gift,” she said. “Treat it as such.”
Talking About Death: A Chicago Idea
Posted on Thursday, October 16th, 2014 at 3:43 pm by lifemediamatters
Chicago Ideas Week, an annual city-wide programming series of speakers and hands-on experiences, dubs itself a “community of curiosity.” The audience gathered on a dreary, rain-drenched night this week at Northwestern University’s Thorne Auditorium for “Death: An Unexpected Take On Life” is evidence of many Chicagoans’ curiosity about death and the dying process.
“Your life will be better, longer and more fulfilled if you take some time to talk about your death,” said Dr. Jennifer Brokaw, a San Francisco-based physician and founder of Good Medicine, a consult, planning and care coordination service; she is also the daughter of former NBC News anchor and current special correspondent, Tom Brokaw. Her talk aimed to help the mostly “Millennial” crowd navigate conversations with family members and doctors about health care goals.
Brokaw told tales of almost a decade and a half spent in emergency medicine, during which she saw patients with each passing year becoming frailer and more troubled by growing numbers of chronic conditions. Resuscitation happened too frequently, she said, often leading to stints in intensive care units and ultimately, death. The Dartmouth Atlas on Health Care reports that 30 percent of patients spend one week or more in ICUs in the week prior to death. “In this country, we load you with tubes and electrodes and send you off in a haze of beeping machines,” Brokaw said. “Even though I may have saved their life today, the bigger picture still was not good.”
“It’s not a matter of if your healthcare agent will act on your behalf, it’s a matter of when”
That “big picture” prompted her career shift into advance care planning, helping patients to spell out the health care they want at the end of their lives. “We will be able to extend life a lot, but how do you want to live and at what cost to your family, emotionally and financially?” Brokaw asked.
Creating a “quality care plan,” she said, involves three steps: 1) naming a healthcare agent, 2) communicating goals and 3) infusion of values.
Health care agents are essential not only for ill or older people, but for anyone 18 or older- especially those inclined to risky endeavors like skiing, rock climbing, biking- or even driving fast cars. This health care agent is able to make decisions on a patient’s behalf if he or she is unable to communicate. An agent may be legally recognized by downloading and competing state Health Care Power of Attorney forms, on a website like Everplans.
“It’s not a matter of if your health care agent will act on your behalf, it’s a matter of when,” she said, citing data from the Journal of the American Medical Association that 50 percent of those 65 and older needed health care decisions to be made by another person within 48 hours of hospital admission.
With a health care agent in place, goals of care should be conveyed to that agent at regular intervals, as goals of care often change over time. What medical treatment the 20-something audience may desire in the case of an emergency could differ if they were diagnosed with a terminal illness, were living with multiple chronic conditions, or when they grow older. Another way to think of goals of care, Brokaw said, is by asking the question “What do I want to do until the day that I die?” For her, that goal was to have the ability to communicate with her family. If her health condition rendered that impossible, Brokaw said she would want to opt out of high-intensity medical treatment.
The third step, infusion of values, is something that likely only needs to be done once, as Brokaw said these personal beliefs do not vary much over time. Values that should be communicated to one’s agent include any religious convictions regarding certain medical treatment- like blood transfusions- beliefs about organ donation, and wishes for the disposition of one’s body- burial, for example, or cremation. With personal reflection about goals and values and the appointment of a healthcare agent, patients are more assured of receiving the care they desire in a health crisis, Brokaw said.
In situations of non-emergent crisis, patients should be able to start an informed discussion with a physician about any particular treatment that may be offered. Three questions should be asked before undergoing any therapy: 1) what are the benefits of a treatment? 2) what are the risks of this treatment? and 3) are there any alternatives?
“Everything in life is incentivized,” Brokaw said, but possible financial or professional incentives of a physician or health institution should not preclude a patient from receiving the care that aligns with their personal goals and values.
“What your physician’s goals are at any given time may be different from your own,” she said. “You have to give your physician the opportunity to get on the same page as you.”
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