Death Is Inevitable. Doctors Should Be Prepared to Manage It Appropriately. (conversation, screaming)
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End-of-life communication is a skill that must be practiced and honed
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One of the few facts that binds all patients is the inevitability of death. Many find it hard to get this step right. As a hospitalist, I strive to be for my patients the physician my aunt deserved. This is often an uphill battleopens in a new tab or window with many barriers, even for those with the best of intentions.
While many physicians receive training for ACP in medical school, this may be their first and last exposure. Communication is a skill, just like a procedureopens in a new tab or window, that requires repetitive and iterative honing.
Many doctors do not feel comfortable having these conversations after only a few hours of study. If this teaching is entirely housed in medicine clerkships, we inadvertently signal that the responsibility lies with some doctors and not others...
I was not Daniella's doctor, I was her niece, and I carry this weight that was not mine to bear. Every patient deserves a medical team equipped to support them at the end of life. It is their right and we must oblige.
I wish that CD allowed me to post this in multiple threads and also post the entire article
Please take a few minutes to read this incredible story
Make sure that your wishes for end of life care are known by your family and have a Medical Durable Power of Attorney with your wishes clearly stated
We just revised our Will and Trust. During the conversation with our attorney, he brought up that we had to revise our Power of Attorney and Medical Power of Attorneys because the wording needed to be changed due to new state requirements
Talk to your family and doctors (and lawyer) before it is too late for you to do so
Doctors don't keep us living at life's end, so much as they keep us dying.
I haven't decided why.
One possibility is that Doctors simply can't stand death and they will do anything to prolong your life so they don't have to deal with your dying.
Another very real possiblity is that the lucrative money is simply just far too good for too many in the medical machine, to just let you die rather than keep you alive while collecting huge insurance payments and draining your personal net worth.
I haven't decided which but there are probably elements of both in it. You can tell the priority of the medical machine when it almost completely avoids education and training in a field of medicine such as the end-of-life planning discussed in the artice, where a 4-month med student had more sense about it than the experienced doctors.
For whatever reason, they want to keep us hooked up, drugged up, and bedridden in perpetuity while time and effort goes completely wasted for someone on death's doorstep that would be better spent treating someone young with a correctable condition. It is illogical.
I remember when my husband was in the hospital for the last time. His oncologist had to tell us there was nothing else to do, and looked rather stricken as he left the room. The hospitalist explained that some doctors have a hard time facing a patient's death.
Everyone over retirement age should have a living will. AND discuss your wishes with your family members. And consider a DNR when something drastic happens. There are very few good outcomes when they "bring back" someone elderly.
Bless in our small town, Bruce was just a few weeks from 65 when diagnosed with Stage 4 esophageal cancer. Ambulance took him to the hospital, BP 80/40, internal bleeding.
Radiation given I recollect, to.prevent more internal bleeding. Chemo we stopped.
Doctors respected our decision.
6 months to the day, Bruce went to his Eternal Home.His earthly journey was complete.
Death Certificate I had to read for any corrections, asked the doc, why smoking, for reason of, Bruce had quit 20? years before, said it didn't matter !
I have found this article to be of great information. In it it touches on why doctors keep patients alive, from running tests to useless procedures. Short and interesting article. From Readers Digest.
The hospitals are afraid of lawsuits if the patient dies in one of their facilities. If your terminal it’s off to home hospice where you’re responsible for everything.
Doctors don't keep us living at life's end, so much as they keep us dying.
I haven't decided why.
One possibility is that Doctors simply can't stand death and they will do anything to prolong your life so they don't have to deal with your dying.
Another very real possiblity is that the lucrative money is simply just far too good for too many in the medical machine, to just let you die rather than keep you alive while collecting huge insurance payments and draining your personal net worth.
I haven't decided which but there are probably elements of both in it. You can tell the priority of the medical machine when it almost completely avoids education and training in a field of medicine such as the end-of-life planning discussed in the artice, where a 4-month med student had more sense about it than the experienced doctors.
For whatever reason, they want to keep us hooked up, drugged up, and bedridden in perpetuity while time and effort goes completely wasted for someone on death's doorstep that would be better spent treating someone young with a correctable condition. It is illogical.
Many years ago when my father was dying of terminal kidney failure and his body was shutting down, his surgeon wanted to operate to "save him." My mother never said no, she felt that there was always hope. She overrode me and said yes.
Dad suffered another week and finally (and thankfully) died. The same surgeon came in the room while Dad was still warm and said that he would like to order an autopsy "to help future medicine"
I told him that he and I could talk in the hall while Mom was saying her goodbyes.
I asked him why he wanted to subject the family to this indignity? He told me the same thing he had said in the room. I put my hand on his shoulder, pulled him close and said that I would approve the autopsy ONLY if I received a copy of the report to prove last week's surgery was unneeded, except to make him more money. Then I would sue his ass
many years ago when my father was dying of terminal kidney failure and his body was shutting down, his surgeon wanted to operate to "save him." my mother never said no, she felt that there was always hope. She overrode me and said yes.
Dad suffered another week and finally (and thankfully) died. The same surgeon came in the room while dad was still warm and said that he would like to order an autopsy "to help future medicine"
i told him that he and i could talk in the hall while mom was saying her goodbyes.
I asked him why he wanted to subject the family to this indignity? He told me the same thing he had said in the room. I put my hand on his shoulder, pulled him close and said that i would approve the autopsy only if i received a copy of the report to prove last week's surgery was unneeded, except to make him more money. Then i would sue his ass
needless to say, he didn't order the autopsy!
bravo
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