In the United States nearly eight out of every ten hospital deaths have no formal pain management. More than eight out of every ten older long-term care facility residents experienced untreated or under-treated pain at the time of death. While seven out of ten people on Medicare who are dying, regardless of their age or where they died, received inadequate amount of pain management. People in the United States are dying in pain.
Most Americans--three of every four--do not fear death as much as we fear being in pain at the time of death. Despite these clearly stated and seemingly universal preferences, too many of the 3 million Americans who die in health care settings each year suffer needlessly in pain at the end of life.
Persons dying from prolonged illnesses can, and should, experience a “good death”. And we know exactly what that means. For most of us a good death consists of dying at home, surrounded by family, and free from pain and suffering. And our preference to die in such a dignified manner is consistent regardless of one’s age, gender, ethnicity, or religious background.
However, by following Christian and Protestant fundamentalist beliefs people who are dying are less likely to have access and select methods for hastening the process of dying. In the United States, approximately 25% of all U.S. deaths occur in the long-term care setting, and this figure is projected to rise to 40% by the year 2040.
The belief in an afterlife--and the support from caregivers who share the same belief--must contribute to the fact that being religious is negatively associated with fear of death. But there is also the worry that some religious beliefs, because of their emphasis on natural death, preclude you from pain medication that might hasten death and taking control over what for most of us will be a painful final passage through life.
Although religious doctors were significantly less likely than their non-religious colleagues to provide treatment with at least some intent to shorten life, when religious doctors did provide such treatment they were significantly less likely to have discussed this with their patient. And this is the unspoken secret of hospitals.
Physicians prescribe pain medication that hastens the final passage of death in a clandestine manner. We live (or die) in an atmosphere of silent favors to alleviate pain.
The Universal Declaration of Human Rights: Article 5 “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” The renowned physician Jack Kevorkian's final push to bring this issue to the Supreme Court--where it should be legitimately decided and which they arrogantly refused to hear—only resulted in pushing him into jail. Because of religious self-censoring we are not approaching the issues head-on. We are therefore resigned to repeating the same mistakes. Older adults in the United States will continue to die in pain.
As Susan Imhof and Brian Kaskie have argued, “we can only conclude that public policies will fall even further behind the advancement of evidence-based pain-policy guidelines, and the number of Americans who continue to suffer needlessly in pain at the time of death will only increase.”
© USA Copyrighted 2013 Mario D. Garrett
In memory of Uncle Freddie who died after a protracted illness.