CAMBRIDGE, Massachusetts — From the intensive care unit to the hospice, Dr. Jessica Nutik Zitter has long been an eyewitness to the end-of-life debate in the US. Now she aims to refocus the conversation.

In her new book “Extreme Measures: Finding a Better Path to the End of Life,” Zitter addresses the tensions between using machines to preserve patients’ lives and treating them through palliative care.

Her goal is “to ensure the death that you want,” she told The Times of Israel in an interview in Harvard Square. “I really believe that people have the right to choose their own death. The main problem is that people are not informed. Usually, it’s a default death, by protocol, as we continue to ramp up technology.”

She discusses the choice between what she calls “the end-of-life conveyor belt” and palliative care, and writes about how patients and their families — including her own extended Jewish-American family — have dealt with approaching death.

“If it’s a high-tech death, [they should know] what it’s going to look like — the prognosis, the benefits, the burdens,” she said. “If they still want to do it, God bless them. Most people don’t. The honest truth we hear is that they want to die with family members.”

A graduate of Stanford University and Case Western Reserve University Medical School, Zitter is trained in pulmonary/critical care medicine and palliative care medicine, and practices at Highland Hospital in Oakland, California. In 2012 Highland had the most-trafficked emergency room in Alameda County. Zitter was also featured in the Oscar-nominated emergency-room documentary “Extremis.”

In her book, Zitter defines palliative care as “an interdisciplinary approach to managing suffering in the context of medical illness, whether physical, emotional, familial or spiritual,” and adds that “for patients approaching the end of life, its offerings are often critical.”

Zitter presents palliative care as an alternative to a painful death — over 50% of Americans die in pain. She cites studies indicating that palliative care and hospice prolong the lives of patients.

And she mentioned a 1996 support trial “that showed the dismal state of dying in America… We were shocked at the rate of mechanized deaths, suffering, poor communication, lack of knowledge. It was grisly. Palliative care arose from that point.”

‘We were shocked at the rate of mechanized deaths, suffering, poor communication, lack of knowledge’

She also credits billionaire philanthropist George Soros, “who decided to get into [the] end-of-life [movement] after bad experiences with his parents dying.”

Soros’s Project on Death in America (PDIA) funded training in end-of-life care for over a decade. Zitter was part of PDIA’s sixth year. She had already participated in a support trial at Case Western Reserve University. In 2003, she was part of a similar trial program at University Hospital in Newark sponsored by the Robert Wood Johnson Foundation. (…) Read Full Publication Here

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