每日外刊丨1217 - 越来越多的美国人选择在家中善终

自20世纪初以来，第一次有更多的美国人在家里而不是医院里死去，这一趋势反映了临终关怀的增多，以及朝着大多数人所说的那样的目的前进。根据周三发表在《新英格兰医学杂志》上的报告，养老院的死亡人数也有所下降。“这是件好事。《退伍军人事务波士顿医疗系统》的主要作者海德·沃莱奇博士说：“在上个世纪，死亡已经被过度医疗化了”，这显示出一种背离。Betsy McNair，现在住在墨西哥的导游，为她帮助她父亲的结局感到骄傲。2009年罗伯特·麦克奈尔得知自己患肺癌6周后，在弗吉尼亚州贝尔海文的家中去世，享年83岁。“他想吃什么，我就给他做什么。他每晚喝一杯苏格兰威士忌，生活质量很高。她说：“如果他在凌晨2点醒来，想喝咖啡和吃馅饼，那就是我们所做的。”。

You never know what you can do till you try. — Marryat

For the first time over a half century, more people in the United States are dying at home than in hospitals, a remarkable turnabout in Americans’ view of a so-called “good death.” In 2017, 29.8 percent of deaths by natural causes occurred in hospitals, and 30.7 percent at home, researchers reported on Wednesday in the New England Journal of Medicine.

The gap may be small, but it had been narrowing for years, and the researchers believe dying at home will continue to become more common. In Boston in 1912, about two-thirds of residents died at home. By the 1950s, the majority of Americans died in hospitals, and by the 1970s, at least two-thirds did.

Americans have long said that they prefer to die at home, not in an institutional setting. Many are horrified by the prospect of expiring under florescent lights, hooked to ventilators, feeding tubes and other devices that only prolong the inevitable. Advocacy groups have encouraged families to have difficult conversations about end-of-life care, which often reveal that older relatives do not want heroic measures to extend their lives in hospitals.