The Best Care Possible

Monday, March 19, 2012

Palliative-care physician Dr. Ira Byock argues that end-of-life care is one of the biggest national crises facing us today, and that politics has trumped reason when it comes to addressing the issue. In The Best Care Possible: A Physician’s Quest to Transform Care through the End of Life Dr. Byock explains what palliative care is and why he believes we must reform our health care system and move past our cultural aversion to talking about death.


Dr. Ira Byock

Comments [7]

Howard from SF from San Francisco, CA

I admire Dr. Byock's progressive work that is helping patients deal with their end of life issues. Long over due. Unfortunately many people go about their business unprepared for what will happen to all of us sooner or later. Death.

I have been diagnosed with a terminal type of cancer and have had to deal with many similar end of life issues on my own. It has not been an easy task I can tell you. I agree with the doctor that us baby boomers need to demand end of life care that is consistent with our beliefs and personalities. We need to care for the whole person not just their disease. I am not only my disease and its complications. It is a important part of me but only a small part of what makes me who I am. I still have my curious mind and my favorite things to do for enjoyment and my personal ethics and beliefs. I have many personal goals I still want to accomplish before I check out for good. I have had my share of chemo and pain. I am lucky that my doctor's are more educated about pain care and they are willing to provide me with powerful opiates that are the only thing that takes the edge off and helps to manage my pain. Yes, we have come a long ways since the days we were growing up. But we still have a long way to go as the doctor has pointed out.

Great conversation on this very important topic. Thanks Leonard!

Mar. 19 2012 11:43 PM
Jennifer from NYC

Three of my family members died long and painful deaths made much more excruciating by the medical establishment. One of them took six months to die - one considerate member of the prestigious medical center outside of Boston said in their 30 years of existence they had never seen a more agonizing death, yet there was never any acknowledgement of this during the dying process and it certainly was not reflected in the care or management of the dying person or their family. Another was kept alive by machines long after it was suggested they be turned off due to the extreme emotionality of a family member, a lawyer, who threatened the hospital with a lawsuit. The third's painful death at a hospice upset the nurses as it was a holiday weekend and the dr. on call would not come in or raise the level of pain killer needed, contrary to nurse's wishes.
Suffice it to say the management of all three of these cases was grossly lacking; true palliative care would of been the most humane for all involved and the least we can expect from a civil society. The lack of discourse, much less medical training on death and dying is truly confounding. I applaud Dr. Byock's efforts and IMPLORE WNYC to explore these issues further. (It would also be very helpful to see coverage on nonprofit vs. for profit hospice and hospital care.)

Mar. 19 2012 02:49 PM
MichaelB from Morningside Heights

A true pleasure listening to this very wise and experienced man & professional. It all seems so much common sense, and yet we as a society seemed to have sooo lost our way in this arena.

Will it ever improve? Whatever the themes were that got us to this point, the same cultural currents probably exist AS WELL AS a completely dysfunctional political climate -- incorrectly framing many of these issues.

Mar. 19 2012 01:46 PM
Lisa from Morris County, NJ

I work in an assisted living facility and I see an alarming trend of putting residents on hospice who aren't actively dying anymore than anyone else. By putting the resident on hospice, the staff at the facility gets a break, the family gets cheap or free diapers or supplies and they stay in the facility so the rent keeps coming.

Mar. 19 2012 01:45 PM
John A.

I oversaw closely the Hospice care and death of my father. In his last five days for him to have died at home (he didn't) I feel he should have had IV morphine for things to have been humane.

Mar. 19 2012 01:40 PM
Karen from NYC

I am 61 and really upset by the "good death" movement, which appears to represent a cultural "meme" developing as more people grow older and more expensive-- particularly the baby boomers. All of a sudden, we're hearing about how expensive and useless end-of-life care may be. (Of course, if you receive the care and DON'T die, you're not counted in the statistics, so all you're saying is that caring for sick old people costs money.)

I have re-written my health care proxy and living will to ensure that nobody cuts off my care, and I will never be bullied into committing suicide. You're trying to kill me, and you won't succeed.

These horror stories are subtley coercive. Take heed, older people, because the kindly progressives, well-meaning or not, are aiming at you.

Mar. 19 2012 01:32 PM
Henry from NJ

I had to watch my brother die an agonized drawn out death in one of the New York hospitals, with a tracheotomy device rammed in his windpipe - neither fully man now nor machine. Caught up in catchwords and symbols rather than reality, we forget that sometimes to let someone slip away in peace rather than prolong the senseless torment is the real grace we owe each other.

A holocaust survivor who fought in WWII, he deserved a better death, as do we all.

Mar. 19 2012 12:51 PM

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