American healthcare doesn’t do a good job of planning for death. I would also argue it doesn’t do a good job of accepting death. If you go to your gynecologist, they’ll ask you if you’ve thought about getting pregnant and how you’d like to manage that possibility. How many times has a physician asked you if you’ve thought about dying and how you’d like to manage that possibility?
I get it; death is an uncomfortable topic. But it is also a very medical topic, and by avoiding it, we fail our patients.
Atul Gawande is a genius and a writer. He is also a surgeon and researcher at Harvard Medical School, and his piece, “Letting Go,” in the New Yorker a few years back is required reading to understand why we need to discuss death honestly in order to serve our patients.
On an individual level, we also need to be more open about discussing death with our loved ones. Our bioethicist David Magnus cites an example that I won’t forget. Imagine you’re a 29 year old medical student. You are debating whether to discuss your medical wishes in the terrible event that you become incapacitated. You think about it, come to the conclusion that it would only depress your loved ones to discuss it, and you avoid the conversation.
But think of the alternative. If god-forbid something happened to you, your loved ones would have to bear the burden of deciding whether to take you off life support and end your life. The emotional burden of having to execute this decision can be devastating to families. Dr. Magnus has seen this first hand. By discussing your medical wishes early on, you can remove the enormous emotional burden of having to make that choice from your loved ones.