Two very different personal experiences with end-of-life care led author Stephen Kiernan to take a closer look at how life ends for many Americans. Stephen talks with Dr. Oz about his book Last Rights: Rescuing the End of Life from the Medical System and the need for training in palliative care, treatment that relieves suffering and pain for patients living out their last days.
Stephen says his father died in an intensive care unit and there wasn't much flexibility for family contact before his death. Four years later, Stephen says his mother passed away at home, surrounded by family. Stephen says his father's hospital experience focused more on medical issues and prolonging life, which didn't allow for much spiritual binding of the family. In contrast, he says his mother chose to spend her final days at home, and family members were able to feed her meals and share intimate moments of conversation. Through his experiences, Stephen says he discovered a need for more physicians to be trained in end-of-life care.
"It's not a sexy discipline, but it's necessary," Stephen says. With the number of Americans above age 80 doubling by 2030 and the need for Medicare coverage growing as well, paying for healthcare could bankrupt the nation, Stephen says. Now that palliative care has been recognized as a subspecialty, residency programs are showing up around the country. "It's not going to draw the person who otherwise would have been a surgeon," Stephen says. "But those drawn to psychiatry or other nonmedical focuses would be a good fit."
At some point during treatment, even the greatest physician isn't able to prolong life and Stephen says doctors may only be prolonging agony. The courts, religions and healthcare systems all have different approaches to end-of-life care, but Stephen says the ultimate decision should be left up to the patient. He says everyone should have an advance directive. "It's a document saying, 'Here's the kind of care I will want and the person who will speak for me.'"
Stephen says, ultimately, healthcare consumers are responsible for advocating for themselves. "We need consumer interest in end-of-life issues to raise awareness on a national level," he says. As we learn more about palliative care, Stephen says our compassion for each other will grow. "It makes me very hopeful for the human race that this opportunity we have—to make death a beautiful, fulfilling and loving event, with forgiveness and reconciliation and preparation—could make us a better society," he says.