Jun 5 2012

21st Century Responsibility

We’re living in an age of increasing personal responsibility for our own health and healthcare.

Think about it.

There’s an explosion of information available on the Internet about any disease or condition imaginable. ”Lifestyle choices” are now recognized as significant contributors to our own health and well-being. Patient and family support groups are everywhere. Pharmaceutical ads tell us to “ask our doctors…” Practically everyone is calling for increased “patient empowerment.”

No matter how you look at it, we are more responsible for our own healthcare.

And, that means that we also have responsibility for how we die.

Author Susan Jacoby wrote about that responsibility in a recent New York Times op-ed. In it, Jacoby tells the story of her 89 year-old mother’s death last November.

Jacoby’s mother sounds like she was a feisty woman. A year before she died,

"She asked a doctor, “Is there anything you can do here to give me back the life I had last year, when I wasn’t in pain every minute?” The young medical resident, stunned by the directness of the question, blurted out, “Honestly, ma’am, no.”

And so Irma Broderick Jacoby went home and lived another year, during which she never again entered a hospital or subjected herself to an invasive, expensive medical procedure."

That’s because decades earlier Irma Broderick Jacoby had completed a living will.

We know that over 80% of us believe it’s important to record our end-of-life wishes in writing. We also know that less than 25% of us do.

Irma Broderick Jacoby wrote that living will after a harrowing experience as a hospital volunteer.

"She once watched, appalled, as an adult daughter threw a coffeepot at her brother for suggesting that their comatose mother’s respirator be turned off. Because the siblings could not agree and the patient had no living will, she was kept hooked up to machines for another two weeks at a cost (then) of nearly $80,000 to Medicare and $20,000 to her family — even though her doctors agreed there was no hope."

Instead of spending her final days in a $6,000 per day Medicare-funded hospital room, Irma Jacoby chose the comfort and dignity of a hospice (at only $400/day).

Susan Jacoby said this about her mother’s death,

"Without advance directives, even a loving child may be ignorant of her parent’s wishes. My mother remained conscious and in charge of her care until just a few days before she died, but like most women over 85, she was a widow. My younger brother died of pancreatic cancer two weeks before she did. It was an immense comfort to me, at a terrible time, to have no doubts about what she wanted."

So, Irma Broderick Jacoby, a woman ahead of her time, took responsibility for her own death.

Unlike most Americans.

Susan Jacoby wrote,

"There is a clear contradiction between the value that American society places on personal choice and Americans’ reluctance to make their own decisions, insofar as possible, about the care they will receive as death nears."

When it comes to one of the most important decisions of our lives, we freedom-loving Americans more often than not give up our choices and leave the responsibility in the hands of others, through inaction.

Unlike years gone by, a free, simple, secure service like means there’s no longer any excuse for inaction, for not creating our own advance directives.

Like Irma Broderick Jacoby, that means we no longer have any excuse for not only being responsible for how we live, but also for how we’ll die.


Advance Directives Advance Medical Directives End-of-life Decisions MyDirectives New York Times

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