Op-Ed: A Home Death Isn't Always the Right Option

Dying in your own bed has become the gold standard of a "good death." Pulmonary and critical care physician Daniela J. Lamas argues in the New York Times that this script is far too narrow—and can leave families feeling like they failed when a loved one dies in the hospital instead. Lamas describes how policy and culture have elevated home deaths as the ideal, with Medicare even flagging late-stage ICU use as a sign of poor cancer care. But "sometimes intensive care is the right place to care for a dying patient," writes Lamas.

Through examples of patients whose symptoms were too volatile for home hospice, she makes the case that a supported death in an ICU can be peaceful and dignified: rapidly adjusted medications for crushing breathlessness, sedation that eases panic, and relief for families that can be present instead of acting as ad hoc nurses at 2am. By contrast, bringing such patients home may result in a "panicked and painful death." The right answer isn't always clear-cut, but it's time to reassess options, writes Lamas. Read the full essay.