(Garrison, NY) Daniel Callahan, bioethicist and cofounder of the Hastings Center, has not only written about end-of-life issues for more than 40 years, he has also been interviewed by countless reporters covering this subject. Most recently, Lisa Krieger of the San Jose Mercury News interviewed him for an article describing the death of her 88 year-old father – a death that was prolonged, at a cost of $323,000, despite his "do not resuscitate" and "desire for a natural death" directives. Krieger found herself in the midst of a “medical nightmare” in which each escalating attempt to help her father failed. He died four days after heroic measures ceased.
“If we look at what's coming down the road in technology, we have to realize that this endless fight against aging can't go on,” Callahan said in the article. “What medicine provides is more and more ways to keep people going -- an extra few days, or a month -- it is very, very hard for doctors and families to give that up.”
Krieger was stunned by the extent of reader reaction. Her voice mail filled immediately. She received more than 200 e-mails. Callahan was so taken by what Krieger wrote that he decided to turn the tables and interview her about her experience. Their exchange appears in Bioethics Forum.
Callahan asked Krieger about reader reaction. “It was as if people just wanted permission to talk about dying,” she said. “I opened the door.”
He also asked when, in looking back, she thought life-sustaining efforts should have been stopped. “Suddenly that ‘do not resuscitate’ order seemed unclear; its black-and-white legal language didn't really apply,” she said. “You keep waiting for the perfect time to stop. There is no perfect time.”
Krieger also offers advice to others who may find themselves in a similar situation. “This is what I would have done differently: I would have asked [the doctors] for a road map. A plan. What are we doing, and why? Where are we headed? Let’s say he survives and makes it out these hospital doors. Then what?”
What does Krieger think should have happened?
“I wish someone had told me about the range of choices. ‘We can do everything. Or we can do some things, but not others. Or we can do nothing, but keep him comfortable.’ That conversation never happened.”
Callahan thinks that modern medicine is partially responsible for the quandary that Krieger and so many others face as loved ones approach death. “Medicine has become increasingly skilled technologically in keeping the dying alive. Krieger noted that her father ‘. . . thanks to modern medicine . . . lived decades longer than his father.’ That same medicine gave him a miserable death. That is a dilemma of modern medicine we have yet to resolve."
Reporters wishing to interview Daniel Callahan should contact:
Michael Turton, Communications Associate, The Hastings Center, firstname.lastname@example.org, (845) 424 4040 ext. 242.