Sparky Anderson died yesterday. The baseball world is mourning the loss of one of its greatest managers, most colorful characters and a beloved mentor to talented young players.
I was struck by the news that Sparky died, of complications from dementia, just one day after entering hospice care at his home in Thousand Oaks, California. The details of his illness and death are private. We don’t know the circumstances. But too often, people with a terminal illness enroll in hospice care long after they would have benefited from its focus on living the fullest possible life when time is short.
A manager makes constant choices: Which players will he put on the field and who will rest? Should his team sacrifice for one quick run or play for a big inning? Can this pitcher get the team out of a jam, or has he got nothing left to offer today? A manager can’t make those decisions without information. He relies on his coaches to help understand his own players and scouts to know the opposition.
Too often, a lack of information denies patients the ability to make informed end-of-life decisions. A recent study concluded, “Many patients whose health status and treatment preferences suggest that they might benefit from hospice are not having a discussion with their clinicians about hospice as a treatment option.”
Empowering patients to make informed end-of-life decisions is a physician’s ethical obligation, and in California, it is a legal requirement. The California Terminally Ill Patient’s Right to Know End-of-Life Options Act (R2K) requires a physician, when asked, to provide the patient with information they otherwise might not be willing to discuss, such as referral to hospice or the right to terminate treatment.
Sparky once said, “The trick is to realize that after giving your best, there’s nothing more to give.” For a terminally ill patient, “the best” could mean fighting to prolong life, focusing on the quality of the days they have left, or balancing the two goals. The patient has to make the call about how they want to spend their remaining days. R2K ensures patients diagnosed with a terminal condition have the information they need to make the call.