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Opinion: Accepting death difficult for doctors, but needs to be done

By The Washington Post  
   October 19, 2011

We will all die, but the trajectory of our death will follow one of a few predictable patterns. According to statistics published in 2003 in the Journal of the American Medical Association, two-fifths of us will die with prolonged, dwindling illness on a slow downward slope typical of dementia or frailty. One-fifth will die with a sharp decline typical of, for example, metastatic cancer. Another fifth will die with intermittent dips, like a roller coaster, from heart or lung failure; and a small percent will die suddenly and unexpectedly, like falling off a cliff. Nearly 80% of us want to die at home, polls have shown, but most die in the hospital, often strapped to a bed in the intensive care unit.

We will all die, but the trajectory of our death will follow one of a few predictable patterns. According to statistics published in 2003 in the Journal of the American Medical Association, two-fifths of us will die with prolonged, dwindling illness on a slow downward slope typical of dementia or frailty. One-fifth will die with a sharp decline typical of, for example, metastatic cancer. Another fifth will die with intermittent dips, like a roller coaster, from heart or lung failure; and a small percent will die suddenly and unexpectedly, like falling off a cliff. Nearly 80% of us want to die at home, polls have shown, but most die in the hospital, often strapped to a bed in the intensive care unit.

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