What Price Paternalism?

More

I'm probably going to have a lot of thoughts about this Atul Gawande piece on hospice care, but here's a slightly off the wall question:  how much better off are patients now that doctors don't lie to them?  My understanding is that in the late nineteenth and earlier twentieth centuries, and possibly right up through the fifties and sixties, doctors routinely lied to terminal patients.  That's changed, partly due to changing cultural views about this sort of paternalism, and partly, I suspect, because we can somewhat extend peoples' lives by doing many unpleasant things to them.  Since no one would put up with this unless they knew they were dying, we have to tell them they're dying.

Gawande's piece, however, makes a pretty credible argument that a lot of the things we do are next to useless, prolonging neither quality nor quantity of life.  If that's the case, couldn't one possibly argue that we'd be better off if more doctors lied, made us comfortable, and let us enjoy our final days without constantly entertaining thoughts of impending death?

I don't like public paternalism, and I'm not much fonder of the private version.  But I'm genuinely curious as to what sorts of benefits people think we gain by knowing for certain that death is coming.  We romanticize the good death, but from what I understand, death has almost always been nasty and brutish, whether long or short.  How is it improved by knowing it's coming?  I haven't had a lot of relatives die, so I'm sure I'm missing quite a lot.  I'm hoping my readers can fill me in.

Jump to comments

Megan McArdle is a columnist at Bloomberg View and a former senior editor at The Atlantic. Her new book is The Up Side of Down.

Get Today's Top Stories in Your Inbox (preview)

CrossFit Versus Yoga: Choose a Side

How a workout becomes a social identity


Join the Discussion

After you comment, click Post. If you’re not already logged in you will be asked to log in or register. blog comments powered by Disqus

Video

CrossFit Versus Yoga: Choose a Side

How a workout becomes a social identity

Video

Is Technology Making Us Better Storytellers?

The minds behind House of Cards and The Moth weigh in.

Video

A Short Film That Skewers Hollywood

A studio executive concocts an animated blockbuster. Who cares about the story?

Video

In Online Dating, Everyone's a Little Bit Racist

The co-founder of OKCupid shares findings from his analysis of millions of users' data.

Video

What Is a Sandwich?

We're overthinking sandwiches, so you don't have to.

Video

Let's Talk About Not Smoking

Why does smoking maintain its allure? James Hamblin seeks the wisdom of a cool person.

Writers

Up
Down