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title: ""George Phillips has his death planned out. His wife Betty has…"
date: 2019-04-20
source: facebook
type: Archer T. Ships shared a link.
---

# "George Phillips has his death planned out. His wife Betty has…

*April 20, 2019 · Facebook*

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[https://www.npr.org/sections/money/2014/03/05/286126451/living-wills-are-the-talk-of-the-town-in-la-crosse-wis](https://www.npr.org/sections/money/2014/03/05/286126451/living-wills-are-the-talk-of-the-town-in-la-crosse-wis){target="_blank"}
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\"George Phillips has his death planned out. His wife Betty has planned hers. They have filled out an advance directive, outlining how they want to die.\
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Their neighbors across the street have filled out the same paperwork, as has the family next door. In fact, in La Crosse, Wisconsin, you\'re unusual if you don\'t have a plan for your death. Some 96 percent of people who die in La Crosse have an advance directive or similar documentation. Nationally, only about 30 percent of adults have a document like that.\
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In this community, talking about death is a comfortable conversation --- neighbors gossip about who on the block hasn\'t filled out their advance directive.\
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It\'s become such a comfortable conversation basically because of one guy in town. Bud Hammes works as a medical ethicist at a local hospital called Gundersen Health System. For years, he was called when someone\'s dad had a stroke, was in a coma, on machines. Bud would sit down with the family and try to help them figure out what to do next. And every time, he says, the discussion was excruciating.\
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\"The moral distress that these families were suffering was palpable,\" he says. \"You could feel it in the room.\"\
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Most of the time, Bud says, they\'d be talking about a patient who had been sick for years. Why not have that conversation earlier?\
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So Bud started training nurses to ask people ahead of time, would you like to fill out an advanced directive. It took a while but the idea caught on.\
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Nurses started asking patients questions like: If you reach a point where treatments will extend your life by a few months and side effects are pretty serious, would you want doctors to stop, or continue to do all that could be done? And a lot of patients said: Stop.\
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And stopping, of course, is less expensive than continuing treatment.\
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\"It turns out that if you allow patients to choose and direct their care, then often they choose a course that is much less expensive,\" says Jeff Thompson, CEO of Gundersen.\
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In fact, La Crosse, Wisconsin spends less on health care for patients at the end of life than any other place in the country, according to the Dartmouth Health Atlas.\"\
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[https://www.npr.org/sections/money/2014/03/05/286126451/living-wills-are-the-talk-of-the-town-in-la-crosse-wis](https://www.npr.org/sections/money/2014/03/05/286126451/living-wills-are-the-talk-of-the-town-in-la-crosse-wis){target="_blank"}
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