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When to pull the plug

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Is there really such a thing as a fate worse than death?

Seriously ill patients at a Philadelphia hospital certainly think so.

In a novel study, researchers asked 180 patients with advanced cancer, severe heart failure or restrictive lung disease, to rate various states of functional debility relative to death, including incontinence, mechanically-assisted breathing, being bedridden, relying on a feed tube, chronic moderate pain, and being confined to home or a wheelchair.

Two-thirds thought suffering bowel and bladder incontinence or relying on a breathing machine to live would be equal to or worse than death, as was being bedridden.

Just over half thought being perennially confused would be equal to or worse than death, as was being in constant need of care.

By contrast, few thought being confined to a wheelchair, being in constant moderate pain or being stuck at home all day was such a grim fate. And though a third thought relying on a feeding tube to live was worse than death, more thought it was preferable to dying.

The study was published in JAMA Internal Medicine.

Adrian Rollins

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