I agree with the approach and support it wholeheartedly. But I doubt it can be implemented in the US - screams of “death panel” will no doubt drown out the sense it makes.
It’s okay if the doctor is a Republican.
I’ve worked with a number of Alzheimers people, a long time ago. They made a lot more sense to me when I realized it was like they were dreaming, and all their nonsense would make perfect sense by dream-logic. Nursing home staff can be pretty good at making it not be a bad way to go at all – sometimes.
Gawande is brilliant and his message important for both a more humane and a more affordable health care system. BUT and this is the really depressing bit: When you search for End of Life Care the research Gawande refers to is hidden and difficult to find. It was publicly funded by the US Institute of Medicine and it is buried under all the RCT on cancer miracle cures promoted by the pharma industry. Here the link to spread the word http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853806/. And for good measure here a link to an insightful article on the damage RCT can do by ignoring the question of the quality of life http://blogs.bmj.com/bmj/2014/11/17/richard-lehmans-journal-review-17-november-2014/…
I just attended a couple of lectures given by a dream worker who said essentially the same thing. He says that the dreaming world and the “real” world are not as different as we think.
On the other hand, that’s Stephen King’s definition of horror.
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