13 Feb 2017

Modern medicine and mortality

From Jesse Mulligan, 1–4pm, 3:07 pm on 13 February 2017
elderly hands

Photo: 123rf

Modern medicine means death is no longer a single binary event, but a phase at the end of life, a cardiologist says.

Dr Haider Warraich believes talking about what we’d like to happen at the end of our lives is one of most important things we can do for ourselves as patients and as human beings.

Growing up and going to medical school in Pakistan acquainted Warraich with death as it would have been in Western countries 100 years ago, he says.

There weren’t many resources to keep people alive and most people died without anyone even knowing what they’d died of.”

Arriving in the States he saw medical technology had brought about a very different experience of dying - with patients, family members and doctors often forced to make difficult decisions.

“Even though there is a lot of value in all those years we have added, they do present a challenge that we need to confront.”

Society hasn’t yet caught up with science, says Warraich.

“Now that we can live through many conditions that would have been fatal – such as infections, heart attacks – it means we get to live with chronic diseases for a much longer time. That has changed death from being a single binary event to almost a phase of our lives – people live with multiple chronic diseases in and out of the hospital.”

Doctors don’t often ask patients about their personal wishes for how they’d like to die.

“Just as if you asked ten different people ‘What is a good life?’ you might get ten different answers. I think that is true also of death.”

One patient whom Warraich met during his training – a woman with multiple incurable cancers – told him what she most wanted was to be around for her daughter’s wedding.

He helped come up with a plan to hold the daughter’s wedding at the hospital.

“That was probably one of the most meaningful things I’ve done as a physician.”

Dr Haider Warraich is the author of ‘Modern Death: How Medicine Changed the End of Life’.

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