Are we being treated, and overtreated, to death?

Hope springs eternal. But that American tendency to fight death to the bitter end might not be the best way to depart this mortal coil.

Doctors can't tell you how long a patient will live, but they usually know when an illness is incurable, according to the Associated Press.

Yet doctors persist in practicing "exhaustion medicine"--treating until there are no more options left to try--Dr. Martha Twaddle, chief medical officer of Midwest Palliative & Hospice Care Center in suburban Chicago, told the AP.

More than 80 percent of patients with progressive chronic illnesses such as cancer, heart failure or Alzheimer's disease, say they want to avoid hospitalization and intensive care when they are dying, according to the Dartmouth Atlas Project, which monitors healthcare trends.

Yet hospitalizations during the last six months of life have risen for Medicare recipients between 1996 and 2005. Nearly one in three Medicare dollars goes toward treating chronic illness in the last two years of life.

Meanwhile, the average amount of time spend in hospice and palliative care, which stresses comfort and quality of life after an illness becomes incurable, is dropping because people start too late. In 2008, one-third of people had it for a week or less, according to the National Hospice and Palliative Care Organization.

"People are actually now sicker as they die," Dr. Ira Byock, director of palliative care at Dartmouth-Hitchcock Medical Center told the AP. Often families push for treatment, choosing needless medicine that prolongs suffering over comfort care. But "there are worse things than having someone you love die," he said.

See Marilynn Marchione's Associated Press article on the subject for a closer look.

F is for Fat (or should I say Fatter)

The Trust for America's Health has just released its seventh annual report on obesity and the results are depressing. Here are the highlights of the report:

Adult obesity rates rose in 28 states over the past year. Only the District of Columbia experienced a decline in adult obesity rates.

More than two-thirds of states (38) now have adult obesity rates above 25 percent.

Eight states have rates above 30 percent: Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma, Tennessee and West Virginia.

In 1991, no state had an obesity rate above 20 percent.

Adult obesity rates rose for a second consecutive year in 15 states and rose for a third consecutive year in 11 states.

Mississippi had the highest rate of obese adults at 33.8 percent. Colorado had the lowest rate at 19.1 percent and is the only state with a rate below 20 percent.


The news about childhood obesity is equally depressing.

Highlights from the report:

State-specific obesity rates ranged from a low of 9.6 percent in Oregon to a high of 21.9 percent in Mississippi.

Eight states, plus the District of Columbia, have childhood obesity rates greater than 20 percent: Arkansas, Georgia, Illinois, Kentucky, Louisiana, Mississippi, Tennessee and Texas.

Nine of the 10 states with the highest rates of obese children are in the South, as are nine out of the 10 states with the highest rates of poverty.

Go here to read the full report.