In medical school, no one teaches you how to let a patient die.
Thanks to 21st century advancements in medicine, people are living longer. However, longer doesn’t always mean better. Sometimes it means quite the opposite: a painful, drawn-out process that causes suffering for not only those who are sick, but also the family and friends who love and care for them.
I became a doctor because I wanted to be a hero. I elected to specialize in critical care–to become an ICU physician–and imagined myself swooping in to rescue patients from the brink of death. But after the terrible experience of my first code, in which I found myself cracking the ribs of a patient so old and frail it was unimaginable he would ever be able to breathe again, I began to question my choice.
In our current medical culture, the default care is high-tech and aggressive, with a focus on resuscitating organs rather than tending to the whole patient. The old and the ill are too often put on what I call the ‘End of Life Conveyor Belt.’ Many are intubated, catheterized, and sent away to care facilities to live out their final days alone, confused, and often in pain.
Yet this is not what patients say they actually want. Data shows that patients who understand the range of options available at the end of life both live and die better. They choose to use far less technology and they suffer less pain. According to their loved ones, these patients enjoy significantly improved quality of life before dying. A 2009 study of 627 cancer patients showed that patients who had engaged in exploratory conversations about end of life preferences with their doctors made very different choices than those who hadn’t. For example, only 1% died on breathing machines compared to 14% who had not had these conversations. Some 5% chose chemotherapy, compared to 10% who had not discussed the options. Only 1% received electric shocks when their hearts stopped, compared to 9%. And only 3% died in the ICU, instead of 13%. Both groups lived the same amount of time. But according to family, the patients who had spoken to their doctors lived much better, with less pain and distress.(…) Read Full Article Here