Why Doctors Choose to Die Gently — and Refuse the Care They Give Patients

Retired family physician Ken Murray argues that doctors, when facing terminal illness, consistently opt for far less aggressive treatment than they routinely administer to their own patients. Having witnessed the reality of “futile care” — patients cut open, intubated, and kept alive in the ICU at enormous cost and suffering near the end of life — many physicians privately want no part of it for themselves. Some go so far as to wear “NO CODE” medallions or get tattoos instructing colleagues not to perform CPR, a procedure whose success rate for the severely ill is vanishingly small despite popular belief.

Murray traces the gap between what doctors want and what the system delivers to three forces: patients and families who, overwhelmed and uninformed in a crisis, demand that “everything” be done without understanding what that entails; doctors who acquiesce to avoid difficult conversations, damaged trust, or litigation; and a fee-for-service structure that rewards intervention over restraint. He illustrates the human cost with cases — a mentor with pancreatic cancer who declined treatment and died peacefully at home, and patients whose aggressive interventions led to amputations, prolonged agony, and death anyway.

The piece, originally influential in reframing end-of-life discussions, is ultimately a call for realistic expectations and advance planning. Murray suggests the emotional toll of delivering care that inflicts suffering contributes to higher rates of depression and substance abuse among physicians, and that clearer communication about what medicine can and cannot accomplish would spare many patients a painful, isolated death they never actually wanted.