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Barbara Bush her Decision, Barbara Ehrenreich and Hers

Barbara Bush her Decision, Barbara Ehrenreich and Hers

Hours before her death it was announced that Barbara Bush had decided to suspend any further medical intervention that might prolong her life. 

Bill Hutchinson reported for ABC News on April 15, 2018 "Former First Lady Barbara Bush, who has been battling congestive heart failure and chronic obstructive pulmonary disease, has decided not to seek additional medical treatment and go home from a hospital to be "surrounded by a family she adores," according to a statement released Sunday by the office of former President George H.W. Bush. Mrs. Bush, 92, has been hospitalized several times in Houston, Texas, over the past year to be treated for chronic pulmonary disease and congestive heart failure, her family has said."

I thought this announcement was both savvy and brave. The family alerted the news media to get their obits ready, at the same time they were being politely asked to stand down and let the former first lady and her family be in peace. 

I wonder though about the language: someone 92 years old battling disease. Could her body just be doing what bodies do eventually: stop working. How many procedures had she endured to get her to this point in the "battle"? Each individual's choice should be their own; in the best of circumstances and a trusted loved one's in the scenario where one is no longer able to speak for oneself. 

Less than 48 hours after her announcement Barbara Bush died. 

On the same day I heard Barbara Ehrenreich speaking with Melissa Block on NPR about her new book Natural Causes ; An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer.” 

Ms. Ehrenreich is not suggesting that we all start smoking and eating twinkies for breakfast, but she does have some provocative ideas about how we view aging. 

Ms. Ehrenreich wrote: "Once I realized I was old enough to die, I decided that I was also old enough not to incur any more suffering, annoyance, or boredom in the pursuit of a longer life. I eat well, meaning I choose foods that taste good and that will stave off hunger for as long as possible, like protein, fiber, and fats. I exercise—not because it will make me live longer but because it feels good when I do. As for medical care: I will seek help for an urgent problem, but I am no longer interested in looking for problems that remain undetectable to me. Ideally, the determination of when one is old enough to die should be a personal decision, based on a judgment of the likely benefits, if any, of medical care and—just as important at a certain age—how we choose to spend the time that remains to us."

This sounds so sensible and one would hope it would be easy to implement, but I suspect that depending on who your doctor is and how your family feels about a decision like this; it could be VERY complicated. 

Reading more of what Barbara Ehrenreich has written, you will realize just how fraught this choice can be. 

Unlike most of her friends, she " had a different reaction to aging: I gradually came to realize that I was old enough to die, by which I am not suggesting that each of us bears an expiration date. There is of course no fixed age at which a person ceases to be worthy of further medical investment, whether aimed at prevention or cure. It is sad when anyone dies, but no one can consider the death of a septuagenarian “tragic,” and there will be no demand for an investigation."

Whatever you think of Barbara Bush's choices or Barbara Ehrenreich's choices the essential thing they should be to each of us as individuals. It is our life and death, after all. 

Physician blogger John M. Mandrola advises:

Rather than being fearful of not detecting disease, both patients and doctors should fear healthcare. The best way to avoid medical errors is to avoid medical care. The default should be: I am well. The way to stay that way is to keep making good choices—not to have my doctor look for problems.

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