Tomorrow's Death: Less Expensive, Less Painful

As reported in the St. Louis Daily Record, Kiernan's talk, Changing Landscape ... Emerging Legal and Ethical Issues and the End of Life focused on "the premise that America needs a less expensive, less technology-based and less painful way to die. As Americans live longer . . . they're less likely to die the sudden death that was prominent in the 1970s as they are a long, slow and ultimately inhumane death in 2008. Americans are dying differently . . . often longer and at greater physical and monetary expense.

Kiernan warns that America is largely unprepared. "At present, only six medical schools nationally require an end-of-life course, and just 18 percent of medical graduates received any formal training in understanding and mitigating end-of-life issues. As a result, elderly Americans are r outinely admitted to $10,000-a-day hospital intensive-care units and stay there, when they might be treated more humanely and far less expensively with palliative or hospice care."

To view dying differently, Kiernan suggests that "the country will need more hospices, improved palliative care in hospitals or at home, better legal protection for physicians who have become wary of prescribing pain medicine and succinct advanced directives that better reflect a person's wishes. It hasn't happened yet. As proof, Kiernan points to his own health-insurance coverage. He's insured for up to $1 million for ICU treatment, but just $5,000 for hospice care. In our country medical care is often confused with love, and they're not the same . . . ."

" It would take a paradigm shift to convince Missourians that living as long as possible isn't always the right thing. It's hard to make this argument in a Right to Life state like Missouri, but it needs to be done."