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Finding more balance in decision making at the end of life


Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

wonderful series of healthcare articles focusing on care issues in phila. inquirer. karen

[color=#4385b7]medical challenge: finding more balance in decision making at the end of life

sun, oct. 17, 2010

by michael vitez

inquirer staff writer

...what, if anything, should america do when families insist on continuing life support even though doctors and nurses believe it just prolongs dying?

and why, finally, on july 14, did prince pulido decide to let his mother die?

path of aggressive medicine

about 2.4 million americans die every year, an estimated 400,000 in an intensive care unit.

most americans don't want an icu death, but many start down a path of aggressive medicine that takes them there. some doctors say they themselves are partly to blame. they need to do a better job early on telling patients with chronic illnesses the risks and grim realities that likely lie ahead.

but doctors get paid to treat, to do procedures. and they don't get reimbursed to have difficult and time-consuming conversations, to deal with family members who want explanations or have objections. it's easier for doctors to say, "go for it."

increasingly, patients who start down that aggressive road are deciding - when hope is gone - to surrender, to focus on comfort at the very end, doctors say. palliative care teams, meeting with families, have helped that happen.

for those who choose - or whose loved ones choose - not to surrender, they can live longer than ever these days because of care advances in the last 10 years. these therapies won't restore the brain, lungs, or liver, but they can prevent or delay the blood infection that might have killed the patient earlier.

read more: http://www.philly.com/inquirer/front_page/20101017_medical_challenge__finding_more_balance_in_decision_making_at_the_end_of_life.html#ixzz12ghy6bne

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subee, MSN, CRNA

Specializes in CRNA, Finally retired. Has 49 years experience.

This issues in this article need to be presented over and over in every news forum we have. This is just the start to the great national debate we must have before we can become educated enough to make more rational decision for dying patients who haven't, can't or won't express their own wishes.