If you were the one who had metastatic cancer, what would you want your doctors to do?
July 26, 2010 9:53 AM Subscribe
What should medicine do when it can't save your life?
posted by ocherdraco (36 comments total)
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Atul Gawande looks at the system of final-stage treatment for terminal patients, which, despite more than 40 years of a hospice movement
for better end of life care, often ensures that patients die exactly how they least want to: in a hospital, hooked up to machines. Gawande tries to envision how, "when the chemotherapy stops working, when we start needing oxygen at home, when we face high-risk surgery, when the liver failure keeps progressing, when we become unable to dress ourselves" medical care can focus on quality of life, rather than prolonging it.
Gawande discusses how, in many cases, advance directives
are not enough: family members need to know not only what medical care a patient does or does not want, but they also need to have the difficult conversations
about the minimum quality of life a person would like to have in his or her final days. (Gawande quotes one patient: "Well, if I’m able to eat chocolate ice cream and watch football on TV, then I’m willing to stay alive. I’m willing to go through a lot of pain if I have a shot at that.")
Read more about palliative care reform
at the Palliative Care Policy Center, the history of hospice care
from the Hospice History Programme, and about the founder of the hospice movement, Dame Cicely Saunders