The Downside of Life Prolonging Technologies

As an ICU physician, I’ve used technologies like breathing machines and feeding tubes to save lives that would have been lost just a few decades earlier. But I’ve also seen the substantial costs, both human and financial, of some medical advances. Many patients die protracted deaths while being kept alive by machines—which, research shows, they would not have chosen had there been adequate communication about their options beforehand.

It's a difficult subject, but advances in medicine have some potential quality of life downsides. In an obsession with doing anything we can to save people, often people are left paying exorbitant amounts of money to live a painful existence.

Prolonged Mechanical Ventilation, or PMV, is a condition of permanent dependence on machines. It is much more common in the elderly, and as the population ages and more elderly patients are at risk for respiratory failure, more patients will be placed on breathing machines, unlikely ever to be freed from them. Patients with PMV cannot live at home and must remain in facilities where they are cared for by personnel trained to run these machines. These patients live permanently connected to life-prolonging machines by tubes surgically placed into their necks and stomachs. Most will never get out of bed again, eat independently, or talk. Their arms will be tied down in order to prevent tubes from becoming dislodged. This is how they will live until they die.

Our system's adherence to profit once again encourages these types of expensive procedures to be recommended and patients and their families are often not provided an accurate understanding of what life will look like moving forward.

Taking this a step further, my grandfather passed away recently and had always been adamant that he did not want to be alive if he was severely incapacitated either mentally or physically. While in his last days he was in pretty rough shape, we were all fortunate that his decline was quite rapid and he didn't spend long in an uncomfortable place. While it was possible to institute a do not resuscitate, there are no other options in the vast majority of the U.S.

If you are in favor of such ideas consider supporting legislation around death with dignity.