July 2000 | Jerseyans Prefer Death to Life In Pain
Rebecca Goldsmith
Star-Ledger Staff
16 July 2000
The Star-Ledger
FINAL
19
English
(c) 2000 The Star-Ledger. All rights reserved.
New Jerseyans do not want medical treatments that prolong pain even if the treatments also forestall dying. But most don't take steps to make sure their wishes are honored.
Nearly nine of 10 New Jerseyans surveyed in the latest Star-Ledger/Eagleton-Rutgers Poll think that while patients shouldn't be forcibly kept alive on machines, fewer than one in five actually have given their doctors instructions on how they would want to be treated.
Three-quarters believe family members should be allowed to discontinue medical treatment for their loved ones, even if the patient left no clear guidelines. Given the choice between living longer with pain, or easing it and possibly shortening a life, seven of 10 said they'd opt to reduce their pain.
"I'd rather drop dead jogging than languish somewhere," said Betty Lacy, 54, of Madison, one of the few New Jerseyans surveyed who has written guidelines for her family and doctor if she becomes gravely ill.
The poll numbers, collected from 802 New Jerseyans in telephone interviews between June 8 and June 13, suggest that as the population ages, images of elderly people sustained by machines and elaborate drug cocktails - alive in body, but not necessarily mind or spirit - hit closer to home.
Lacy said she was forced to think about her own plans as she watched her father die painfully over three years of pancreatic cancer.
"It was heartbreaking and sickening," she recalled. "I know some people would say, 'God has his plan' and everything, but I just think people in this day and age ... if they want to go, they should go."
The poll, done in conjunction with the Center for State Health Policy, was commissioned by the New Jersey Comfort Care Coalition. The center was formed in January to promote changes that make end- of-life care more comfortable and compassionate.
Questions steered clear of euthanasia, right to die and related practices meant to hasten death. Instead, the survey touched on feelings of whether medical workers should prolong life at the expense of mental health and comfort.
"I wouldn't want anybody hooked up to a life-support system just to keep them going, but I wouldn't just say, 'This person's lived long enough, so don't do anything for them,"' said Thomas Reid, 57, of Waldwick.
Judy Crawford of West Caldwell, a dining hall manager in an assisted-living facility nearby, said she is fearful of the deluge of drug combinations that doctors give to elderly people.
"There are so many combinations of medicines that people receive, and I think it makes the whole process worse. People are on 10 and 15 pills, and doctors just keep medicating," said Crawford, who is 52.
The people most mistrustful of painkilling treatments that could cut short the end of life tended to be older black and Hispanic people with a high school degree or less education.
Mabel Ellis, 71, of East Orange insisted that doctors should keep her alive, regardless of pain or her condition. Fourteen years ago, she was faced with making a similar decision for her daughter, who eventually died after falling into a coma.
"You don't know if they're going to come out of their coma. You don't know what's going to happen," she said, "I feel like nobody has the right to end somebody else's life. I never would have told them to pull the plug on anybody."
Despite their strong feelings on the issue, many haven't provided clear guidelines regarding how they want to be treated in the event of a life-threatening condition.
Almost two-thirds have discussed future health care plans with loved ones - with women (72 percent) far more likely to do so than men (54 percent), but a much smaller proportion have communicated their preferences to their doctors.
Age also was a factor. For those 65 and older, 76 percent reported speaking with family members and 35 percent said they discussed it with a doctor. But those 18 to 30 years old were far less likely to do so: 46 percent said they had spoken with family members, and only 12 percent had discussed it with a doctor.
The survey also highlighted a lack of confidence in the way the health care system treats dying patients and their preferences. One in five respondents said they were "not too" confident that hospital staff and doctors would follow their wishes at the end of their lives.
Four of 10 said they think medical staff do a "poor" or "only fair" job of caring for the emotional needs of patients, and 28 percent were similarly skeptical regarding how health care professionals treat pain near the end of life.
The survey also found wealthier people more likely to express faith in their physicians. Crawford, the dining hall manager, said she has had no health insurance for most of her life and understood why people with lower incomes have less faith in doctors.
"People who have a lot of money can afford the extras," she said.
Pain management at the end-of-life should not be considered "extra," said Stein, who is trying to get the message out that everyone deserves good care.
"People with serious and terminal illnesses have a right to expect doctors to treat their pain and other distressing symptoms when they're sick," Stein said.
1. She's written guidelines for her care, but Betty Lacy of Madison said she'd "rather drop dead jogging than languish somewhere." 2. "I wouldn't want anybody hooked up to a life-support system just to keep them going," said Waldwick resident Thomas Reid. 3. Judy Crawford of West Caldwell works at an assisted-living facility, where she said she sees "so many combinations of medicines that people receive, and I think it makes the whole process worse." The Star-Ledger Eagleton-Rutgers Poll
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