Less than half of doctors would talk about death only if the patient requests to talk about it. Only 43 percent of oncologists would give a prognostic estimate of how much time a patient has left.
Internist Toni Brayer examines why. She says that American society is uncomfortable with death. Given that backdrop, “we offer unrealistic expectations of survival in patients with advanced terminal cancer and patients with end stage cardiac or pulmonary disease.”
End of life care consumes a disproportionate amount of health care dollars, because both doctors and patients fail to compassionately acknowledge mortality. Dr. Brayer further adds that “doctors are stuck between a rock and a hard place because patients don’t want to be ‘quitters’ and they don’t want a physician who will give up.”
I’ve written previously that more care is not necessarily better. No where is that more relevant than in end of life situations.
Related posts:
- Why would a doctor stop seeing patients?
- Should doctors talk politics with patients?
- Death of primary care: Who cares?
- Does good bedside manner mean a better doctor?
- Do not resuscitate or Allow natural death, does it make a difference?
- The New York Times finally gets it on electronic medical records
- Waiting hours to see a doctor, and patients billing physicians for lost time
{ 3 comments }
Well, first I want a doctor I can trust. That said, if there was information I needed to know – as in, yes, we are going to die within two months – I wouldn’t want anyone to give me unrealistic expectations.
This would allow me to get my life in order, enjoy a few things before my time is up, and just get ready.
But simply saying someone is terminal doesn’t mean the doctor should give up. The professional should be there to provide the best service until the end.
Best,
Van
http://vansantos.com
Interesting post…I suppose I’d want to know. On the other hand Doctors are not always right. In 1991 my Father was diagnosed with CLL and Prostate Cancer. We were told less than a year. He lived 9 years more without major intervention, just some pills. His quality of life was good until the last 4 months. My Mother on the other hand was in hospital for a pacemaker, expected to survive and come home soon. She died…food for thought…ciao
I’ve already talked to my doctor about it. We’ve discussed options, legal papers that need to be prepared, what to do when I’m incapable to expressing my health care decisions, etc.
I don’t see the discussion of death with a doctor to be a philosophical one, but a pragmatic one. I expect my doctor to know what I as a patient need to do to prepare for that day. And if I’m in the process of slowly dying (Eg: cancer) I expect him to tell me up front what to expect and his best estimate for how long I have. He may or may not be right, but I would be pissed if he held back information I would use to make informed decisions.
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