Cultural Shift Required

The more I work in health care, the more I realize attitudes toward health care, and its availability, are about culture more so than fact. By this I mean the culture surrounding health care and its relation to death and dying. Here, in the US, we die badly, often without humility, and at great, unnecessary cost. Here, when someone dies, you hear, "They just couldn't do anything else for him/her," or "The surgery was unsuccessful." The culture is death is a failure of medicine. One seldom hears, "She was quite old, 93, and well, it was her time, we were all there and made her comfortable," or "He just did not manage his health well, he smoked, he had bypass already and several stents, he would never take care of his diabetes, his choices led him to an early grave." Death is associated with medicine failing, it is not seen as a normal, inevitable part of life. Thus, we cannot seem to face it with dignity or with grace. In the ICU, often I have to bring up the subject of dying and end-of-life plans with people. Often times I am faced with someone who has not even considered that their aged (think 90+) loved one might...die. The burning question the cynic in me wants to blurt out is, "Exactly how long did you expect them to live??" When did we get so removed from death and dying? That is what the parlor was for back in the day...this is where you laid out the dead to receive those who chose to come and pay respects. The dead were in your home. At what point did we remove ourselves from the only other inevitability other than taxes? And why can we not allow our loved ones to come to their end with dignity? Without "doing everything!!" even when it is, without question, futile? We do not allow our animals to languish in such a state.... Yet for family....Who is the "do everything" ideology really for anyway?