Muhammad Ali, 74, died two days after being admitted to a local hospital on Friday, June 3. The three-time heavyweight champion had been fighting Parkinson’s disease almost immediately after retiring from boxing 35 years ago. He had been hospitalized several times in the past two years for severe urinary infections.
It is often said of the dearly departed, “He died with dignity.” Can patients who are presumably near the end of life and succumb to dying in the hospital still claim to have passed with dignity? Did Ali have an advance care plan or did he let his guard down?
As previously reported by the Associated Press, “He is being treated by his team of doctors and is in fair condition.” In actuality, he had been placed on a ventilator, underwent dialysis and was in critical condition. Were doctors miscommunicating with his family or just with the public? Moreover, was there a greater misunderstanding of Ali being near the end and how he might have been cared for more properly?
Emergency physician, Kevin Haselhorst, MD and author of Wishes To Die For states, “The end of life is not a medical condition, it’s a spiritual destination. In this regard, the experience of coming home often means being surrounded by loved ones amid a dwelling place of comfort and peace.”
Advance care planning is necessary for anyone above the age of 18. Palliative care resources allow patients to keep their guard up and provide additional coaching strategies for both caregivers and patients battling end-stage illness. Ideally, a palliative care team would have protected Ali from the brutality displayed by this gang of aggressive doctors.
What has been said of Ali was that he stood up for his beliefs – practicing Islam and protesting the Vietnam War. The Quran states . . . and if anyone saved a life, it would be as if he saved the life of all mankind. This type of war against death and dying continues to be propagated by the healthcare industry, yet this stance no longer serves humanity and the greater good.
The iconic image of The Greatest lighting the Olympic flame might ignite and inspire a new perspective for how we honor those afflicted with end-stage illness. The final blow to Ali was an assault on his dignity. Dignity is rarely seen in proclaiming greatness and being treated heroically, but rather through abiding in humility and respecting the process of aging and illness. Haselhorst states, “Society needs both a referendum and the referee of good conscience to end the assault on consummate fighters down for the count.”
Presently, Medicare will pay physicians to have end-of-life conversations with patients long before they frequent hospitals and end life through this means. Dr. Haselhorst offers his Terms of Engagement for End-of-Life Discussions as an introspective exercise to ready individuals with self-determination prior to entering the ring of end-of-life conversations. This PDF download is available at www.kevinhaselhorst.com.