Monday, December 04, 2006

Rescuing the end of life


Updated December 5
More and more, the American way of death is an agonizing decline rather than a sudden blow. For millions of the dying, the companions of their last days are machines and medicines that manage to extend the vital signs for hours, days – even, in extreme cases, for years. Too often, those last days are endured, not lived. And that just begins to explain the mission of Stephen P. Kiernan in his new book, Last Rights: Rescuing the End of Life from the Medical System (St. Martin’s Press, 2006).

Kiernan was a writer and editor at the Burlington Free Press, in Vermont. His newspaper work documented his state’s End-of-Life Initiative and the effort to make sure that all Vermont doctors were trained in how to relieve pain, a frequent issue for cancer patients and others with fatal ailments.

In his book, Kiernan takes us to the bedside of several people dying badly – that is, in such pain, confusion and turmoil that they don’t get to settle their affairs, forgive their adversaries, say their goodbyes or even say "I love you" to the ones they love the most.

These cases are contrasted with a few where the patient was fortunate enough to have hospice care, which means that their doctors, nurses, friends and family worked to make them comfortable but employed none of the ventilators, defibrillators and other emergency devices or procedures commonly used to extend life as defined by bedside heart monitor.

In a chapter called "We can celebrate," Kiernan puts the point on his values:
"The last wishes of a seriously ill person have little or nothing to do with death. They are about life, about heightened awareness of its preciousness, about expressing individuality in the pursuit of small joys, about how death is an instant and how every moment preceding that instant is about living in all its fullness."

He concludes with recommendations for steps that the government, the medical professions and you and I can take – on the one hand to end the overuse of resources that barely postpone certain death, and on the other hand to make the last of life the most precious and memorable part.

"When the American culture around dying shifts," he writes, "it will improve medicine, cost less, and help families. But the largest impact will be on patients themselves."

These are wise words, and timely for everyone in the healing professions, anyone active in church or charity work, and all who may become the primary caregiver for an ill or elderly friend or relative.

Kiernan was interviewed for the public radio show "Fresh Air," and that segment is scheduled to run today. You can find where to hear it here. Here are his publisher's page, and Kiernan's own.

1 comment:

Jay Blotcher said...

Thank you for blogging Mr. Kiernan on your site. Thank you for the kind words.

I am currently booking Stephen Kiernan’s speaking tour. We seek venues where he can speak. And organizations which would host him.

Could you suggest any leads? I welcome any and all information.

Pleaes go to his site to learn more: http://www.skiernan.com/

When Stephen Kiernan addressed a palliative care conference recently, an older couple came up to him afterward to thank him for helping them to finally understand their daughter’s death from leukemia. When he spoke to a veterans’ group, local hospice leaders then helped audience members draw up advance directives. When Stephen gave the keynote address at a statewide hospice convention, the hotel had to bring extra chairs into the breakout room for his subsequent workshop.

Stephen’s speeches are based on the thousands of hours he spent with dying people and their families, while researching his book Last Rights – Rescuing the End of Life from the Medical System. An indictment of the costly and dehumanizing approach to end-of-life care in America today, Last Rights uses stories of people from all walks of life to articulate an agenda for greater compassion, less pain, and reforms in law and medical education. Its goal is to help people live as well as they can for as long as they are alive.

Donald Schumacher, CEO of the National Hospice and Palliative Care Organization, commented: “Stephen Kiernan is an incredibly captivating public speaker whose years of journalistic excellence convey a strong message about some of the problems and cures for today’s health system.”

Once Stephen shares with audiences, people rethink their notions about medical care. They hear the horror stories about people suffering needlessly – and conversely about people who received proper, humane care that allowed them to live their final days with dignity.

Thanks again for your praise of "Last Rights." Let me know if you have any ideas as to allies in the community for speaking gigs.