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#219056 - 06/09/13 09:59 PM Should Docs Speak Up When the End of Life is Near?
Anne Holmes Administrator Offline
Boomer in Chief

Registered: 03/12/10
Posts: 3182
Loc: Illinois
I just saw an interesting article in the New York Times that I think is worth discussing. It's titled "The Unspoken Diagnosis: Old Age."

Basically the article discusses the fact that - perhaps due to the Hippocratic Oath? -- very few physicians acknowledge the need to level with patients and their families when the patient has a terminal illnesses and death is near. In fact, many times those kinds of honest, exploratory conversations still don’t take place.

Now Dr. Smith, a palliative care specialist at the University of California, San Francisco, who also practices at the San Francisco Veterans Affairs Medical Center, and two co-authors are urging a change they acknowledge would “radically alter” the way health care professionals communicate with their very old patients.

I'm certainly not in favor of "death panels," as became a concern with those who opposed Obamacare, but I DO think that there are times when families would say that it is more kind to allow a beloved family member who is clearly dying to "go in peace," rather than force the loved one to endure "heroic measures" that will be painful, and - in the end - not really change the fact that the person is going to die.

My experience is that at some time, which is currently called "palliative care" is the better solution.

But that's just my humble opinion. I am sure others would like to weigh in on this topic and I welcome a good discussion.

By the way, here's a link to the full article: The Unspoken Diagnosis: Old Age
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#219060 - 06/12/13 03:53 PM Re: Should Docs Speak Up When the End of Life is Near? [Re: Anne Holmes]
jabber Offline
Member

Registered: 02/17/05
Posts: 9984
Loc: New York State
IMHO the experiences I've witnessed these past few years is that doctors' are already frank. Family members and friends who've gone to be with The Lord, nearly know the exact hour and minute the transition will occur. I visited my cousin and her husband said, "She can go anytime now." A friend said, "They asked me if I wanted "last rights." Another friend's husband said, "she knew she was dying." Another cousins has two weeks to live and yet another has only days left. Methinks they're being blunt enough!!! At least in this area of the country they are!!!
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#219061 - 06/13/13 05:47 PM Re: Should Docs Speak Up When the End of Life is Near? [Re: jabber]
Anne Holmes Administrator Offline
Boomer in Chief

Registered: 03/12/10
Posts: 3182
Loc: Illinois
Well that's OK with me, I think, Jabber.
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#219063 - 06/13/13 09:59 PM Re: Should Docs Speak Up When the End of Life is Near? [Re: Anne Holmes]
Ellemm Offline


Registered: 11/04/08
Posts: 601
Well, it's not that people don't know that someone is terminal, it's that there's still a lot of permission and encouragement to throw every possible treatment at someone. I know that families are understandably upset, but I know of plenty of surgeries and end-stage invasive treatments that have left family members -- who demanded the treatments, by the way -- with the idea that maybe they should have concentrated on quality of life and allowing death with a little dignity.

I think, frankly, that a lot of people have been taught to feel guilty or callous if they don't do everything possible to try and save someone's live, even if it's not possible. Of course, no one wants to seem callous, and it's easy for relatives to get to arguing about what, if anything, to do.

I think there have been a number of studies showing that a great deal of our health care costs are spent near the end of people's lives and don't result in much more than a few weeks' extra time. I think it's natural to fear letting go, but it just makes sense for all of us to issue directives ahead of time -- if we can, of course.

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#219064 - 06/13/13 10:29 PM Re: Should Docs Speak Up When the End of Life is Near? [Re: Ellemm]
jabber Offline
Member

Registered: 02/17/05
Posts: 9984
Loc: New York State
Guess we all have to face facts. cry
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"MOLLIE'S FOLLIES" by Bonnie Mill-Lemke, aka Jabber, is available at the Kindle Store and in paperback on Amazon.com.

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#219098 - 06/18/13 11:48 PM Re: Should Docs Speak Up When the End of Life is Near? [Re: jabber]
maryannewrites Offline


Registered: 05/18/10
Posts: 18
Loc: South Carolina
Several years ago, my dad was diagnosed with lung cancer. My parents were told that he had up to 18 months of life remaining. He began treatment, and he actually enjoyed reasonably good quality of life for a good portion of that period. As if almost on cue, as he approached the end of the 18 month time frame, he began a rapid deterioration. When I arrived from out of state, I was astounded to discover that the doctor was still ordering radiation treatments. Every muscle movement produced pain, and they were preparing to take him yet again to radiation. I said, "Whoa! Stop right here." I took my mom aside and said, "I realize that you want to continue to give him hope, but at this point, he needs to be kept as pain free and comfortable as possible--not being taken for more treatment. It is not going to cure him, and it is hurting him. Let's make him comfortable now." She agreed, but she would never have made that decision on her own, nor did it even occur to her to advocate for him. She just went along with the program because she thought that's what one had to do. Hospice was called in, and his last days were at least peaceful and pain free. He passed away within two weeks. I have absolutely no regrets that we didn't continue putting him through a painful ordeal of treatment as a last ditch effort to keep him here. Quality of life is a huge consideration, and while we risk the appearance of playing "God" in decision-making for loved ones, it is heartbreaking to see your loved one needlessly suffering when the end result will not be altered. The inevitable is merely being delayed at their expense. He was ready to go--physically, emotionally and spiritually...and given the same set of circumstances with my dear mother, I would make an identical decision. I would hope that someone would do the same for me.

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