Thank modern medicine for helping to boost the Western world's life expectancy rates.
Canadians, on average, can expect to live to the ripe old age of 81. But while many seniors can look forward to years of happiness, modern medicine can also intervene in the natural process of dying.People can be kept alive by feeding tubes, drugs and medical equipment.The question is, should they?In some cases, yes, said North York's Dr. Michael Gordon, a leader in geriatric medicine at Baycrest Geriatric Health Care and Mount Sinai Hospital.But in other situations, medical intrusion only serves to make the elderly person's final days an unwanted misery, he said.Gordon tackles end-of-life care in his new book Moments that Matter: Cases in Ethical Eldercare.It is a guide for family members who want to support their parents, grandparents and other elderly loved ones through the difficult and ethical challenges facing them in the later years of their lives. Families may want to do the right thing but because there are no easy answers, they often feel compelled to try every medical option possible to prolong dad or grandma's life."There's often a gap between technology and what people want to do. People get almost drawn into the medicalization," Gordon said."We can see how easy it is to get drawn into the interventionist mode. That is what doctors and hospitals do, they offer what is available. Most people want to do the right thing. The right thing isn't only 'I tried every conceivable drug or surgery'."Gordon has gone through the dilemma of eldercare in his own family."Besides being a doctor, I'm a son. I've been through this with my late mother and with my father, who is 99 now," he said.Gordon said the key is communicating with the loved one, preferably long before a crisis hits and emotional families are trying to guess what their relative would want them to do.While families may feel uncomfortable discussing end-of-life care, he said they are usually gripped with anxiety much more than the elderly relative.There are no absolute answers when dealing with major ethical decisions dealing with an elderly relative, Gordon said. Families can only hope to make the best judgement call based on weighing the options and choosing what they believe is best for their loved one."Ethics, unlike giving a medical consultation, doesn't give you an answer. It gives you a process of evaluation," he said."The problem with this argument (whether to medically intervene or let nature take its course) is how many angels can dance on the head of a pin? There is no answer for it. At the end of the day, a decision has to be made. 'After debating all the sides, I made the best decision possible'."But what if you make the wrong decision?"What if? That is the nature of life," Gordon said."You still have to make a choice based on your values. You have to make a decision because not making a decision is a decision. Things happen."After years in his practice, Gordon believes he can offer helpful ethical eldercare advice.But he takes in stride the prospect of readers discarding his suggestions."People can reject the book. I don't take umbrage," he said."So far, maybe I'm lucky or maybe I'm naive but I've had enough people come to me and say 'It helped.' I've had people say 'I wish I had this (book) before'."For more information about Gordon and Moments than Matter, visit drmichaelgordon.com