Making Death An Option – Healthcare Professionals and End-of-Life Conversations

Original Publishing date: 01-24-2020
Publisher: HuffPost
Author: Kate McLean (board-certified obstetrician gynecologist in Seattle).

The article follows an interaction between a surgeon and her patient for whom treatments are just not responding and the ultimate decision of the patient to choose a peaceful death.  HCP’s many times do feel that it their role, nay responsibility to have end-of-life conversations with patients but are not trained to do so.

“Dying, which was once viewed as natural, is now seen as a medical transaction — one that we seem to hope technology can rescue us from completing.”

Death is inevitable and medicine has its limitations. While medical professionals are trained to save lives, they are not trained to deal with patients who cannot be saved, and it needs to be done. It is important that patients spend their final moments surrounded by the people they love (when they want to of course and don’t want to fight their illness anymore).

“Some patients feel like it’s worth it to them to go through the discomfort of surgery and the side effects of chemo if there is any chance it might help…However, once treatments become less likely to help, other patients would rather prioritize different things, such as pain relief and time out of the hospital with their family.”

Quality of life deteriorates for terminally ill cancer patients when they are put on ventilators or are admitted to intensive care units, moreover, their caregivers are prone to suffering from major depression and myriad other emotions. Caregivers suffer as well when they see patients suffering, whether terminally ill patients should simply accept death or keep struggling is up to them, however, it is worth mentioning that often, prolonging life deteriorates the quality of it.

“Patients who are provided with complete information about their prognosis and treatment options elect to have less intervention than those placed on the ‘default treatment path.’

Withholding information about a patient’s condition, his/her likelihood of recovering etc., would cause a patient to develop distrust in the medical community. It was clear that the patient in the article wanted to know what was next for her and was disappointed when she found out that she would be subjected to treatment despite the chances of it working were very less, and that she was not told about it.

The story highlights the reluctance of physicians to have these conversations due to lack of any formal training. The author presents alternatives to have handled this conundrum better, involving others in the medical team (especially seniors). The need for training, improving “medical culture” and training for improving the healthcare system is imperative and evident.

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