Achieving the Best Care Possible
The following excerpt is from The Best Care Possible: A Physician's Quest to Transform Care through the End of Life by Ira Byock, M.D. Copyright © 2012 by Dr. Ira Byock. Reprinted by arrangement with Avery B00L·, a member of Penguin Group (USA), Inc.
In one sense, the real reason that thousands upon thousands of Americans still die badly is that we collectively allow it to happen. Of course, no one votes to make people suffer. But as a society and body politic we tolerate widespread, needless suffering among seriously ill people and their families and well- documented deficiencies in medical care and social systems.
Our inaction on this crisis of public health is incongruent with our character as a society and culture. We are a caring and generally sensible people. Despite our culturally ingrained avoidance of the topics, in my clinical experience, when push comes to shove, individuals and families move beyond their resistance to talk seriously about how they or the person they love should be cared for through the end of life. Yet collectively, despite overwhelming evidence of pervasive problems, we act as if push hasn't come to shove.
Instead, an amalgam of politics and religion has made dying and end-of-life care culturally toxic. Political correctness and an overt desire to avoid conflict stifle substantive dialogue and debate. Yet open discussion that encompasses medical and social perspectives, including multicultural ethnic and religious worldviews, is exactly what is needed. With issues this big, diverse social dialogue and debate, even if heated, are essential for developing constructive public policies and large-scale corrective actions.
Mortality should be the one thing that brings all people together. In science fiction, when a planet-killing asteroid is headed toward Earth, people set petty differences aside. …