There is a wide gap between what the public believes technology is capable of doing and what technology actually accomplishes. Only when serious illness strikes do families begin to realize that physicians can often do little to change outcomes. It is certainly not well appreciated that large gaps in medical knowledge remain and that many diseases elude treatment. For patients and families who have so little knowledge of our failings, the truth comes as a shock. Many patients and families are ambivalent about what to do when serious illness strikes and death becomes a real possibility.
Patients are confused about having to make life and death decisions far in advance.
This ambivalence also extends to the hospice movement. Hospice offers humane care with an emphasis on the relief of both physical and mental pain. Faced with overwhelmingly complex technology, patients in the United States fear loss of autonomy. They may wish to be saved by technology, but they fear that it will cause them to lose control over their lives and experience a lonely and impersonal death. Physician-assisted suicide, the legalization of euthanasia, medical futility, and the activities of Dr. Jack Kevorkian are discussed and debated throughout the United States.