Dr. Ken Murray on the Zócalo Public Square website wrote in 2011 his How Doctors Die essay about the way his orthopedist friend Dr. Charlie chose to die with cancer as many other doctors tend to do. The essay went viral.
When pancreatic cancer was confirmed, Charlie went home, closed his practice and never went back to another hospital. He chose to spend his last months with family and friends and died at home--with no chemotherapy, radiation or surgery. The article was chosen for the Best American Essays in 2012.
I plan to follow the same route and have made it known to my children and my general practitioner. He tells me I'm uninformed and considers me a difficult patient because I refuse routine tests he prescribes. I just wanted a tiny bump removed on my last rare visit but he referred me to another doctor.
Consulting the World Wide Web, I read several websites about doctors not getting the treatments they prescribe to patients. Back to Dr. Charlie, the surgeon he consulted about the lump in his stomach "was one of the best in the country." He had invented a new procedure for this pancreatic cancer that could triple Dr. Charlie's five-year- survival odds from 5 to 15 percent, although the quality of life would be poor.
Dr. Charlie said no thanks, knowing exactly what was going to happen to him, despite having access to whatever medical care he wished. He knew modern medicine's limits. He had personally witnessed futile best technology care on terminally ill people who were cut, hooked to machines and tubes, drugged and endured thousands of dollars daily worth of torture for themselves and their families and ending up dying in Intensive Care.
According to Dr. Murray, retired Clinical Assistant Professor of Family Medicine at USC, medical personnel wear medallions stamped "NO CODE" so doctors will not do CPR on them and some have it tattooed on themselves. He told how of the hundreds of people brought to him in emergency after getting CPR, only one walked out of the hospital. He wrote "If a patient suffers from severe illness, old age, or a terminal disease, the odds of a good outcome from CPR are infinitesimal, while the odds of suffering are overwhelming. Poor knowledge and misguided expectations lead to a lot of bad decisions."
A 1999 study of 600 doctors published in the journal Resuscitation found "the overwhelming majority of those physicians did not want cardio-pulmonary resuscitation (CPR) performed in the context of incurable illness." See the site for the list of what they considered incurable.
The American Medical Association discusses futile care in Opinion 2.035 saying "Physicians are not ethically obligated to deliver care that, in their best professional judgment, will not have a reasonable chance of benefiting their patients. Patients should not be given treatments simply because they demand them. Denial of treatment should be justified by reliance on openly stated ethical principles and acceptable standards of care...not on the concept of 'futility,' which cannot be meaningfully defined." A key is to find a doctor whose opinion of what is reasonable beneficial care you trust. The government has a lengthier discussion of futile care.
Here it is in print for my children and a copy will be attached to my will. I do not want to be put on life support machines ever under any circumstances. I do not want any heroic measures and do want to die with dignity at home. My life has been about promoting being good stewards of the earth. I want to die as green as possible, no toxic chemicals, no radiation, no wasting hospital resources, no huge medical bills adding to social debt. I prefer to slip quietly into the woods like native Indians used to do and die green like doctors do today. Google "green way to die" and the results are about green funerals and burial methods. I consider Dr. Charlie's choice a true example of a green way to die.
Watch Massimo Mazzucco's video on the $50 billion annual cancer business in the United States and the Big Pharma not environmentally-friendly way to die.