Eugene Fedorenko is Designing, Writing, Reading, and Traveling

A better way to care for the dying

On life expectancy and average lifespan:

Many aspects of death changed during the 20th century. One was when it happens. The average lifespan increased by more over the past four generations than over the previous 8,000. In 1900 global life expectancy at birth was about 32 years, little more than at the dawn of agriculture. It is now 71.8 years. In large part that is a result of lower infant and child mortality; a century ago about a third of children died before their fifth birthday. But it is also because adults live longer. Today a 50-year-old Englishman can expect to live for another 33 years, 13 more than in 1900.

On change in a perspective:

What healthy people think they will want when they are mortally ill may well change when that moment comes. “Life becomes mighty precious when there is not a lot left,” says Diane Meier, a geriatrician at Mount Sinai Hospital in New York. It is common, for example, to hate the idea of a feeding tube but grudgingly accept one when the alternative is death.

On palliative care:

Doctors often neglect palliative care, which involves giving opioids for pain, treating breathlessness and counselling patients. (The name comes from the Latin palliare, as in “to cloak” pain.) A typical question is “What is important to you now?” It does not seek to cure. As a result, “it is seen as what you do when you give up on a patient,” sighs Dr Ikegami. It receives just 0.2% of the funding for cancer research in Britain and 1% in America. […] Since 2009 several randomised controlled trials have looked at what happens when patients with advanced cancer are given palliative care alongside standard treatment, such as chemotherapy. In each, the group receiving palliative care had lower rates of depression; and in all but one study, patients in that group were less likely to report pain.