When Living Longer Conflicts With Dying Well

Top of Mind with Julie Rose

Dying is inevitable. But medical advancements have made it possible to cheat death in many instances that would have been quickly fatal not so long ago. So it’s become easier to avoid thinking about death and default toward saying “yes” to whatever medical intervention will extend our lives. But when does living longer conflict with dying well? In this podcast episode we’re assessing the common assumption that we can extend life at all costs and still have a “good death” when the time comes. A hospital physician explains the complicated financial and emotional incentives that lead doctors and patients do too many tests, prescriptions and procedures that ultimately do more harm than good. An ICU doctor describes the risks of relying on a “living will” to guarantee a “good death” and what to do instead. If you’ve spent a life saying “yes,” by default, to everything medicine has to offer, it’s traumatic – and not at all straightforward – to know when to start saying “no.” We also hear how a man with terminal cancer navigated end-of-life decisions and what it took for his caregivers to deliver on his wishes for a good death in hospice. Podcast Guests: David Oliver (died 2015), retired gerontology professor, University of Missouri, co-creator of “Exit Strategy” video series Debra Parker Oliver, professor of hospice and palliative care research, Washington University St. Louis, co-creator of “Exit Strategy” video series, author of “Legacies from the Living Room: A Love-Grief Equation.” Christopher Moriates, MD, Assistant Dean for Health Care Value in the Department of Medical Education, Dell Medical School at The University of Texas at Austin Samuel Morris Brown, MD, ICU physician and vice president for research at Intermountain Health; professor of medicine, University of Utah; author of “Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human” **This episode is part of Season 4 on Top of Mind: Assessing Assumptions. Could the systems we've built to keep our communities safe and  thriving work better if we weren't so set in our ways?