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Sudden Bonk On Head
Preferable To Long ICU Stay
“How We Die” [First
in a series]
COLUMBUS, OH—With the aging of our
population, and at the urging of health care experts, many Americans
are planning ahead for their deaths. The creation of so-called “advance
directives,” specifically addressing such issues as code status
and other
aspects of palliative care, are one way people currently exert some
degree of control over the way they end their lives.
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The Ohio State University
School Of Medicine
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Dr. Nick Nishida has taken the planning one step
further. He and his colleagues at The Ohio State University School of
Medicine recently completed
a survey in which elderly
patients were asked, simply: “How would you prefer to die?”
Participants were given the choice
of 1) an acute illness requiring an ICU stay with multiple complications including
MRSA contamination, two pneumonias (including at least one aspiration), ischemic
bowel, a large left MCA stroke and death after 3 weeks, OR,
2)
a bonk on the head leading
to sudden death.
Surprisingly, 97% selected the “bonk on the head
leading to sudden death.”
But is the term “bonk” too vague
to have any significance, as some have suggested? Nishida disagrees. “It
doesn’t matter if it’s a pail of
cement that falls off of a scaffolding or your neighbor whacking you with
a ball-peen hammer. The point is, when the time comes, people just want
things to end.
We usually don’t provide that option in this country.”
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Dr. Nick Nishida
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When asked how clinical changes could be implemented
based on this information, Nishida responded, “[that’s] the
beauty of this study - it shows the ease with which we can make changes
to fit people’s wishes. For example, you might fill out an advance
directive that states that you wish to have an anvil dropped on your
head when it’s your time to go.”
Nishida
also acknowledged that some hospitals may need to acquire some new
equipment.
Ben Wachowski of Zanesville, OH, a 77-year-old
man who participated in the survey, said it would be “fun” to choose
his mode of death. “I’d like to get
hit by a Roger Clemens fastball. Too bad I won’t be able to see it though.
It might be fun to watch.” When reminded that Clemens might not be around
when the time came, Wachowski’s wife offered to hit him over the head
with their 1952 Hoover FloorMaster.
Patient advocates are praising the increased
autonomy that would arise from these new forms of advance directives.
Health care analysts, too, are excited
about
the potential cost savings.
Rudolph Hechst, an administrator for Kaiser Permanente
in Los Angeles says that the annual cost savings might be “on the order of
ten million dollars.”
“When you start subtracting out all those
end-of-life ICU stays, the potential fiscal benefits are staggering,” said
Hechst. “Sure,
we’d
need a few anvils and a lead pipe or two, but that’s peanuts in
comparison.”
Nevetheless, the new system has had its
share of critics.
Julian Bass, an 82-year-old man from Warren, OH
complained last May that
deaths
caused by “bonking” would
be
barbaric.
“I survived two
botched murder
attempts
by ex-wives,” said Bass, “one of whom dropped a bowling ball
on my head, and the other of whom swung a hot iron like a whip – fortunately,
the cord broke before I got hurt. So I
can’t imagine what sort of peace or gratification any human being could
get from a bonk on the head. It’s just not right.”
Unfortunately,
Bass was killed recently by his third wife, who dropped a 1973 Chrysler Imperial
on his head as he slept in his home.
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