I missed this MUST-read op-ed from The Washington Post while I was abroad last week so I am urging all ChangingAging readers to read “Our unrealistic attitudes about death, through a doctor’s eyes” by Minneapolis physician Craig Bowron.
So many elements of this editorial have been echoed on ChangingAging that I don’t know where to begin praising Bowron’s critique of American attitudes and detachment from death and its implications on our approach to aging.
He does an excellent job connecting the dots between major socio-cultural trends and the difficulty most people today have making end-of-life decisions for themselves or a loved one.
For instance, when our population shifted from 80 percent living in rural areas at the beginning of the Civil War t0 80 percent living in urban areas today, the vast majority of Americans today are completely insulated from the kind of exposure to the natural processes of death that have always been intimately familiar to those living in rural areas.
I also appreciated his explanation of the widespread misconception of longevity, something Dr. Thomas and I have blogged about frequently. People are not living longer today due to miraculous advancements in modern medicine — people live longer due to very basic improvements in public health and obstretics:
These unrealistic expectations often begin with an overestimation of modern medicine’s power to prolong life, a misconception fueled by the dramatic increase in the American life span over the past century. To hear that the average U.S. life expectancy was 47 years in 1900 and 78 years as of 2007, you might conclude that there weren’t a lot of old people in the old days — and that modern medicine invented old age. But average life expectancy is heavily skewed by childhood deaths, and infant mortality rates were high back then. In 1900, the U.S. infant mortality rate was approximately 100 infant deaths per 1,000 live births. In 2000, the rate was 6.89 infant deaths per 1,000 live births.
The bulk of that decline came in the first half of the century, from simple public health measures such as improved sanitation and nutrition, not open heart surgery, MRIs or sophisticated medicines.
The point of the editorial is that our unrealistic expectations of medical interventions and our unfamiliarity or unwillingness to accept the natural process of death is placing an extraordinary burden on the health care system. As a result, it’s easy for patients and families to demand more tests, more medications and more interventions, even when the procedures become “sanctioned torture.” Please take a look at the entire article and let us know what you think:
H/T to Joe Popiolkowski for alerting me to this piece.