About 40 percent of dying patients die in pain, and nearly half were fed by a tube, ventilated on a machine or given resuscitation in the last days of life, according to researchers.
In the first American study in nearly a century on the perceptions of dying, researchers interviewed the families of 3,300 patients who died and concluded that so many Americans “have such a horrible dying experience that everybody is scared.”
“People cannot be confident they will get a decent care system when they die,” said Joanne Lynn, the study’s principal author. “Terror is still pervasive.”
Lynn, director of the Center to Improve Care of the Dying at George Washington University in Washington, D.C., contends that the need for doctor-assisted suicide - an issue now before the Supreme Court - would largely disappear if America improved care of the dying.
That would include better pain management, more patient autonomy and control, better communication between doctors and patients, more realistic assessment of the patient’s prognosis at the end and less emphasis on high-tech life support in futile cases.
Two key findings from the report, published today in Annals of Internal Medicine:
About 59 percent of dying patients preferred a treatment plan that focused on comfort, but 10 percent received more aggressive care than they wanted.
Forty percent of patients had severe pain most or all of the time in the last three days of life. Eighty percent had severe fatigue.