It seems as if witnessing aggressive, life-prolonging care actually makes people more likely to want it for themselves -- even with all its miseries and ultimate failure -- than they would if they hadn't witnessed it. That's a puzzle. What might be going on?
This latest study reveals not only abject failure, but lost ground as well. It's up to the people -- those approaching the end of life and those who love them -- to prevent medical habit from stealing a peaceful death.
Sadly, informed consent and shared decision-making, the twin pillars of patient-centered health care, aren't the rock-solid structures we would hope for. That's the lesson of a new study in the Journal of Intensive Care Medicine.
One big misnomer in our culture is that doctors (solely) develop a patient's plan of care. No. No. No. This could not be farther from the truth! Patients have a real responsibility to be fully engaged in the development (and revision) of a plan of care.
The medical establishment's support for patient choice exists within a particular, and peculiar, bioethical framework.A problem arises for palliative care physicians when people question their intention.
Knowledge is power. There is no knowledge more important than to have knowledge about what all of your options are as you approach the end of your life or as you make decisions about life-changing conditions.
How do we get doctors to honor our wishes at the end of life? Most recommend preparing an advance directive, and I'm no exception. These documents are not infallible, but they are the best things we've got going for us when we can't speak for ourselves.
ASCO's admonition to avoid ineffective treatment is unlikely to constrain the use of chemotherapy in advanced cancer significantly, because although it's good advice, it's difficult to put into practice.
A bizarre aspect of murder-suicide episodes is that reporters, commentators or the killers themselves speak of them as "loving" acts. When a husband kills his sick wife and then himself, he is said to act out of compassion or understandable desperation.
There is a spectrum in the process of dying. It ranges from unbearable suffering for patients and their families to a reasonable quality of life in which symptoms are controlled until the end. Either way, survivors are left to grieve.
On the one hand, we may be able to sympathize with doctors' reluctance to be the bearers of bad news, including the reality of imminent death. On the other hand, there may be some real negative consequences that result from their reticence.
It may sound peculiar, but there are some very exciting things happening where death is concerned in America. The momentum of change in how we view and respond to death is building in many sectors of society as we transform our culture of death.
A competition to design new hospice uniforms is an opportunity to see how multi-faceted hospice care is on the broader scale, and how smaller details can make a difference in the end-of-life care patients receive.