living your best to the end

Dr James Downar: death is as precious as life

He seems far too young to be dedicated to minimizing suffering at life’s end, but that is, indeed, Dr Downar’s mission. His three specialties are inter-related: critical care, ethics and palliative care. Palliative care changes the focus from cure to comfort. This sensibility doesn’t fit with the military language often used in healthcare situations: battling, fighting, giving up, winning, losing. Dr Downar’s take puts that tough language into ‘life’s end’ perspective: “In healthcare, you’re always fighting. At life’s end, what your fighting for changes and what one person means by fighter is different than for another. The goal is to determine what you’re fighting for.” When people are asked about Cardiopulmonary Resuscitation (CPR), they often answer without understanding what is involved, and what the consequences may be. CPR can cause pain and suffering, and studies show that the survival rate after CPR in the hospital is very low. “When the heart stops, it’s usually not a random event. For 95 per cent of the population, death is a predictable event caused by a chronic and incurable disease.” Dying has become a foreign concept for many boomers “An unanticipated consequence of modern medicine is that many adults have never seen someone die. It’s not like previous generations where the dying were attended to at home. As a result, we have trouble accepting death, and we may request therapies that will fix a small problem but actually worsen the quality of life for a dying person.  We need to be comfortable with the idea of improving care by NOT trying to ‘cure’ some problems, such as a pneumonia in a person with...