Dealing with death
The New York Times has a nice update to an issue I discussed months ago – end of life decisions in health care and the angst that accompanies them. Official guidelines call on doctors to begin “the conversation” (about how a terminally ill patient would like to spend their final days) at about 1 year away from estimated death. But it seems that there are diverging opinions on the viability of these guidelines; this “conversation,” after all, is perhaps the most difficult a person will ever face and such emotionally taxing questions are sometimes as difficult for doctors to broach as they are for patients to digest.
One one hand, there’s our desire to remain hopeful as long as possible, if not to the end. Many patients – even when faced with dire forecasts – demand that doctors continue chemotherapy and other intensive (and expensive) treatments even when their effectiveness has worn off. They want to live like Sisyphus, knowledgeable of their unwinnable predicament yet committed to fighting ’till the end.
But of course, fighting costs money, time, and diverts resources away from others, and when patients request major surgeries and experimental treatments in the face of extremely low or impossible odds, utility seems to demand that they be overridden. Can we do so, however, without succumbing to the “death panel” argument? Is there something just inherently wrong about telling the terminally ill to give up?
The existentialist in us says that we can come to terms with our finality without falling into despair, but something tells me that doctors don’t read Camus in medical school.
-Colin
Related posts:
- Death panels and democracy
- Rationing health care?
- Public healthcare, private practice
- Montana allows assisted suicide
- Who lives and who dies?
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As far as I’m concerned, patients should have the right to all the treatment they can pay for; however, they have NO right to all the treatment WE (the public) have to pay for.