Featured Research

from universities, journals, and other organizations

What can we do about death? Reinventing the American medical system

Date:
June 2, 2011
Source:
The Hastings Center
Summary:
In a new article, two scientists propose a radical reinvention of the American medical system requiring new ways of thinking about living, aging, and dying. They argue that a sustainable -- and more humane -- medical system in the US will have to reprioritize to emphasize public health and prevention for the young, and care not cure for the elderly.

In a feature article in The New Republic, Daniel Callahan and Sherwin Nuland propose a radical reinvention of the American medical system requiring new ways of thinking about living, aging, and dying. They argue that a sustainable -- and more humane -- medical system in the U.S. will have to reprioritize to emphasize public health and prevention for the young, and care not cure for the elderly.

An interesting twist on their argument, which would aim to bring everyone's life expectancy up to an average age of 80 years but give highest priority for medical treatment to those under 80, is that Callahan and Nuland are themselves 80 years old. Daniel Callahan, Ph.D., is cofounder and president emeritus of The Hastings Center and author most recently of Taming the Beloved Beast: How Medical Technology Costs Are Destroying Our Health Care System. Sherwin Nuland, M.D., is a retired Clinical Professor of Surgery at the Yale School of Medicine and author of How We Die and the Art of Aging. He is also a Hastings Center Fellow and Board member.

"The real problem is that we have medicine excessively driven by progress, which aims to rid us of death and disease and treats them as the targets of unlimited medical warfare," said Callahan and Nuland. "That warfare, however, has come to look like the trench warfare of World War I: great human and economic cost for little progress. Neither infectious disease nor the chronic diseases of an aging society will soon be cured. Cancer, heart disease, stroke, and Alzheimer's disease are our fate for the foreseeable future. Medicine and the public must adapt it to that reality, one that has mainly brought us lives that end poorly and expensively in old age."

The article notes that the Affordable Care Act might ease the financial burden of this system, but not eliminate it. It reports, for example, that the cost of Alzheimer's disease is projected to rise from $91 billion in 2005 to $189 billion in 2015, and to $1 trillion in 2025 -- twice the cost of Medicare expenditures for all diseases now.

"We need to change our priorities for the elderly. Death is not the only bad thing that can happen to an elderly person," the authors write. "An old age marked by disability, economic insecurity, and social isolation are also great evils." They endorse a culture of care, not cure, for the elderly, with a stronger Social Security program and a Medicare program weighted toward primary care that supports preventative measures and independent living.

Callahan and Nuland point the way to a more sustainable path that reprioritizes the entire system. Among their recommendations:

  • improve medicine at the level of public health and primary care, while reducing its use for expensive high-tech end-of-life care;
  • shift resources for the elderly to greater economic and social security and away from more medical care;
  • subsidize the education of physicians, particularly those who go into primary care, and decrease medical subspecialization;
  • train physicians better to tell the truth to patients about the way excessively aggressive medicine can increase the likelihood of a poor death;
  • shift the emphasis in chronic disease to care rather than cure;
  • conduct a top-down, bottom-up, long-range study of the entire American system of health care, including the training of physicians, with a view toward reconstituting it along systematic lines that take science, humanistic concerns, economics, and social issues into account.

Story Source:

The above story is based on materials provided by The Hastings Center. Note: Materials may be edited for content and length.


Journal Reference:

  1. Daniel Callahan, Sherwin B. Nuland. The Quagmire: How American medicine is destroying itself. The New Republic, May 19, 2011 [link]

Cite This Page:

The Hastings Center. "What can we do about death? Reinventing the American medical system." ScienceDaily. ScienceDaily, 2 June 2011. <www.sciencedaily.com/releases/2011/05/110531141830.htm>.
The Hastings Center. (2011, June 2). What can we do about death? Reinventing the American medical system. ScienceDaily. Retrieved July 22, 2014 from www.sciencedaily.com/releases/2011/05/110531141830.htm
The Hastings Center. "What can we do about death? Reinventing the American medical system." ScienceDaily. www.sciencedaily.com/releases/2011/05/110531141830.htm (accessed July 22, 2014).

Share This




More Science & Society News

Tuesday, July 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com
What Self-Made Women Need to Know Financially Before Getting Hitched

What Self-Made Women Need to Know Financially Before Getting Hitched

TheStreet (July 21, 2014) Halle Berry was recently ordered to pay her ex-boyfriend Gabriel Aubry $16,000 a month in child support by a California judge for their daughter Nahla. As women make strides in the workforce, they are increasingly left holding the bag when relationships end regardless of marital status. 'What Monied Women Need to Know Before Getting Married or Cohabitating' discusses information such as debt incurred during the marriage is both spouse's responsibility at divorce, whether after ten years of marriage spouses are entitled to half of everything and why property acquired within the marriage is fair game without a pre-nup. Video provided by TheStreet
Powered by NewsLook.com
$23.6 Billion Awarded To Widow In Smoking Lawsuit

$23.6 Billion Awarded To Widow In Smoking Lawsuit

Newsy (July 20, 2014) Cynthia Robinson claims R.J. Reynolds Tobacco Company hid the health and addiction risks of its products, leading to the death of her husband in 1996. Video provided by Newsy
Powered by NewsLook.com
Clock Ticks Down on Internet Speed Debate

Clock Ticks Down on Internet Speed Debate

Reuters - US Online Video (July 18, 2014) The FCC received more than 800,000 comments on whether and how internet speeds should be regulated, even crashing its system. Lily Jamali reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins