Blog 2: Letting Go

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Medicine often plays a role in prolonging life, whether it’s through vaccines, antibiotics or preventative tests. But what should medicine & those in the medical field do when it no longer becomes possible to prolong a patient’s life? The article Letting Go discusses the options and the difficulties that patients and their families are faced with when those questions need to be asked.

People are ill prepared to make these decisions when it comes to themselves or to their loved ones. The article gives a glimpse of how people rationalize aggressive options toward their diseases. Preventative surgery, experimental drugs, harsh chemotherapy, all of these are considered and it’s tough to know when to draw the line and say enough is enough. Doctors and patients have this problem. Doctors may find it challenging to confront the patient’s illness even if they know the outcome. These are conversations that need to occur for the benefit of the patient and the doctor. The patient cannot begin to accept their mortality if they don’t fully realize the extent of their illness. Patients need to be kept fully informed and it falls on the doctors shoulders to do so. We won’t be able to move forward past a death denying culture if all we do at the end of life is deny our lives. Doctors ought to accept a formal responsibility and a rationality that no matter how much they train and how much they know, even death can’t be prevented. This isn’t to say that no doctors or patients out there realize this and understand that these things are true. But there is a problem in the health system of doctors recommending care that is no longer truly necessary for the terminally ill.

One of the best options for someone suffering from a terminal illness is to manage the pain effectively. When you’ve reached the point in your life where you’re choosing between enjoying the last few days/weeks/months what have you and spending the time in a cold sterile room patients may opt to spend that time surrounded by their loved ones instead of in a clinical setting. These decisions can often come too little too late, as was almost the case for Sara. However in the end she was able to be with her family and die peacefully.

When medicine can no longer fix, it should manage.

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2 thoughts on “Blog 2: Letting Go

  1. Facing death so closely must be terrifying –with pain or without pain. There is no question that pain and suffering with today’s technology is really unnecessary. Technology, though, causes people at the end of life to “rationalize” as you put it. Naturally we want to live so we continue to hope at any glimpse of another day! Nonetheless, it is a known fact that few survive lung cancer because it spreads to the lymph and body making it nearly impossible to treat.
    You bring up a new and interesting view that the patient has a responsibility. The patient really does need to ask any questions they may have so they can progressively accept their fate. The patient must clearly understand and accept the risks of treatment before making any decision.
    On the other side, a doctor must always bear the burden of where, when and how much to information to forgo –not easy. The doctor has the responsibility to respond honestly to the patient’s questions about the risk of treatment options, their recovery chances, and any side effects of treatment. Some doctors just are not direct enough. I realize some doctors hold back information noting “good bedside manners”. For example, a doctor never says, “Everyone with lung cancer dies and you will too. Get your funeral in order now!” Still, many doctors do not tell the patient the full extent of an illness or withhold information that can be gently told.
    As you say, though, at one point, even the doctor must admit death is inevitable. It seems there has to be a point before the exact moment of death the doctor knows the treatment is futile. This is the point both patient and doctor need to turn to palliative care and forget trying to save the person’s life.

  2. I love your blog post because it addresses the fact that both the doctor and patient need to face the truth much sooner than is usually practiced. There is always the question if the patient would have had a much better experience at the end of his/her life had the doctor just told her that he/she was going to die in the first place. Instead, at the end, both usually focus on a false hope of a cure that they either did or didn’t know would be brought forth. The doctor does have a moral right to tell the patient that their time is coming to an end. However, I believe that if the doctor isn’t compassionate about their patients—as the one in the story is—they are obviously in the wrong profession. Doctors are supposed to care and want to see their patients in the best state possible, whether they know their time is coming to an end or not. Well done.

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