The future of end-of-life care

Dr. Joel Policzer, Lillian Landry
Dr. Joel Policzer checked on Lillian Landry in this Oct. 30, 2009 photo, in the hospice wing of an Oakland Park, Fla. hospital.
J PAT CARTER | AP photo file
Friday Roundtable
MPR News' Friday Roundtable
MPR illustration

As America's population ages, more family members must confront the realities related to end-of-life care. Two physicians and a bioethics expert joined MPR News' Kerri Miller to talk about how to navigate through those decisions.

Interview highlights

Our medical system isn't set up to accept dying

"Very much of the medical system now is set up so that there's a default assumption that people want more done and we're incentivized as a medical system to do more rather than doing less," Dr. Glen Varns, palliative medicine physician at Allina Health said.

Starting end-of-life conversations early can help alleviate the anxiety when a crisis occurs

"It's hard to talk about what happens at the end of one's life," said Dr. Jacob J. Strand, director of Symptom Management, Pain and Quality of Life Clinic at Mayo Clinic. "We see a lot of patients who say things like, 'Well I don't want to go there.' Why would you want to go there? Most of us aren't ready to accept the label that we're dying until the very end. That includes patients, that includes loved ones, that includes clinicians that are caring for them... Being able to make these conversations more normal is a critical part of that."

The language we use to talk about end-of-life isn't effective

It's important to accept your family member's decisions

"When my father became ill with his terminal cancer, he was one of those people that wanted everything," said Susan Wolf, McKnight presidential professor of law, medicine and public policy at the University of Minnesota. "He was adamant until very close to the end... It was his illness, it was his suffering, and it was his death and I needed to respect his choices."

Strand said this is why it's important to have these discussions early. When your loved one makes it clear they want to exhaust all curative treatment options or to end that care, it takes the burden off the family to make those decisions.

"I may not agree with this, this isn't what I would choose for myself, but this is what my dad, my sister wanted and I can carry that out and feel like I did the right thing," he said.

Why hospice gives patients false choices between curative treatment and comfort care