Everything Ends
Every human being has an expiration date. One day, our bodies will shut down; whether it is due to the body’s inability to combat disease any longer or an unexpected death. However, no one enjoys talking about this unfortunate, yet inevitable event. Clinicians deliver bad news to their patients every day, and sometimes even a timeline of how long they have to live. As Atul Gawande, a writer and surgeon, suggests in the film, most doctors have difficulty talking about chronic disease and death with their patients, so instead they avoid these discussions or offer a different medication or therapy. The film documents how Dr. Gawande’s and his colleagues’ have faced the difficulty of having end-of-life conversations with their patients. He refers to aging and dying as the two big unfixables. Clinicians’ expertise and medical training is overcome by feelings of incompetency and defeat when they cannot find a solution to a problem and find themselves at a dead-end. Doctors are humans too, and must accept
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Kathy Selvaggi states, doctors “are taught that in order to be making a difference in patients’ lives, they have to be operating… giving them a medication…giving chemotherapy.” However, that is not always the best for a patient; listening and understanding how patients want their stories to come to a close is the best way to initiate end-of-life conversations. Dr. Gawande outlines important questions that patients must be asked: what are your fears and worries of the future, what are your priorities if time becomes short, and what are you willing to sacrifice and what are you not willing to sacrifice. This allows patients to be proactive in their plan of care and understand that their comfort and decisions are a priority. Perhaps, terminating chemotherapy is the best option for a patient who desires to spend his or her last days in the comfort of his or her home. Medicine also has an end, especially when it can only worsen someone’s overall
When it comes to a bad diagnosis it is often difficult for doctors to tell their patients this devastating news. The doctor will likely hold back from telling the patient the whole truth about their health because they believe the patient will become depressed. However, Schwartz argues that telling the patient the whole truth about their illness will cause depression and anxiety, but rather telling the patient the whole truth will empower and motivate the patient to make the most of their days. Many doctors will often also prescribe or offer treatment that will likely not help their health, but the doctors do so to make patients feel as though their may be a solution to the problem as they are unaware to the limited number of days they may have left. In comparison, people who are aware there is no cure to their diagnosis and many choose to live their last days not in the hospital or pain free from medications without a treatment holding them back. They can choose to live their last days with their family and will have more time and awareness to handle a will. Schwartz argues the importance of telling patients the truth about their diagnosis and communicating the person’s likely amount of time left as it will affect how the patient chooses to live their limited
In “How Doctors Die,” Dr. Ken Murray explains some different real stories about people having terminal diseases, and how their doctors and physicians treat them. Moreover, the author mentions about difficult decisions that not only the doctors but patients and the patients’ family also have to choose. When the patients’ diseases become critical, the doctors have to do whatever they can to help the patients, such as surgical treatment, chemotherapy, or radiation, but they cannot help the patients in some cases. In additions, doctors still die by critical diseases, too. Although they are doctors, they are just normal people and cannot resist all of the diseases. Like other patients, the doctors having critical diseases want to live instead of
Charalambous, A. (2010). Good communication in end of life care. Journal of Community Nursing, 24(6), 12-14. Retrieved from EBSCOhost.
The Dying of the Light is an article by Dr. Craig Bowron that captures the controversy surrounding the role of medication in prolonging life. The author describes that many medical advancements have become a burden to particularly elderly patients who in most instances are ready to embrace the reality of death. Dr. Bowron believes that dying in these modern times has become a tiring and unnatural process. “Everyone wants to grow old and die in his or her sleep, but the truth is most of us will die in pieces,” Bowron notes (Bowron). The article does not advocate for euthanasia or the management of health care costs due to terminal or chronic illness. Bowron faults humanity for not embracing life and death with dignity as it was in the past. He blames the emergence of modern medical advances and democracy as the sole reason why everyone is pursuing immortality or prolonging of life rather than embracing the natural course of things. The article is very articulate and comes out rather persuasive to its target audience that happens to be health-conscious. Craig Bowron uses effective rhetorical strategies such as logos, ethos, and pathos to pass on his message. The article’s credibility is impeccable due to the author’s authority in health matters as he is a hospital-based internist. A better placed individual to dissect this issue by analyzing his experiences in the healthcare profession. The article incorporates a passionate delivery that appeals to the readers’ hopes, opinions, and imagination.
Gawande’s book is very pertinent to the present day and has by many accounts sparked a national discussion on end-of-life care and how we treat our elderly. With elderly people accounting for a greater proportion of the American populace and as people start living even longer than they do now, end-of-life care will become and remain a major issue faced by doctors, patients, their families, and the healthcare system. Additionally, with our greater focus on improving patient outcomes while getting the most value for our healthcare dollars, end-of-life care is a major area that healthcare systems and hospitals will focus on, as it accounts for a large portion of their budget. As a response to the need to take care of our aging population, hospice care and palliative medicine are some of the newer specialties in the medical field that have been increasing in popularity and more research needs to be focused in these areas to better understand how to improve patient outcomes.
The decision to end a life is a difficult one no matter the situation presented. It stirs a great deal of emotions when thinking about a loved one choosing to die in situations where they are terminally ill. Death is a scary thought for most people, but we need to remember that it is just a fact of life, no matter how morbid it sounds. There is some dignity in ending a life for a patient is who terminally ill and suffering, although it may be a tough decision, it can sometimes be the right one.
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
Hospice always patient and families the automaty to decide a choice of end of life care. It allows who prefer to end life in their homes, pain free, surrounded by family and loved ones: Hospice works to make this happen. The focus in on caring, not curing. Hospice utilizes an interdisciplinary team of healthcare professionals and trained volunteers that address symptom control, pain management, and emotional and spiritual support expressly tailored to the patient's needs and wishes. Hospice is not “giving up,” nor is it a form of euthanasia or physician assisted
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
It is found that nurses report that their most uncomfortable situations come with prolonging the dying process and some struggle with ethical issues by doing so (Seal, 2007). Studies have shown that implementation of the RPC program and educating nurses have increased the nurses’ confidence in discussing end-of-life plans (Austin, 2006). With confidence, the nurse is able to ask the right questions of the patient and make sure that the patient’s wishes are upheld in the manner that they had wanted, such as to not resuscitate or to make sure their spiritual leader is present when passing (Austin,
While the majority of the book critiques the healthcare system, Chapter 13 focuses more on key actions and personality traits that help Dr. Stone relate to patients. Although this noteworthy, compassionate physician attempts to develop an understanding of his patients’ values and goals, he still fails Mrs. Jackson by trying to retain cultural competency by tiptoeing around end-of-life decisions. Conversations about feeding tube placement and DNR orders could have minimized Mrs. Jackson’s unnecessary
There isn’t a doctor that can definitively say when you’ll die. They can certainly measure the odds like a Las Vegas bookie, but ultimately some will always win against the house. Aunt Wanda had an inoperable brain tumor and was given six months to live. Five months later, her doctor called telling her of a physician that wanted to try a new procedure. She decided to allow the doctor to try the operation to advance medicine. The surgery was a success. She lived another 15 years. When we seek death instead of life we lose the opportunity to impact the world in a positive way. Not all will be as large as Aunt Wanda’s contribution, but will be impactful all the same. It could be that we need one more day to say the very thing needed in another’s life. There are ways to mitigate suffering yet hold true to morals. Hospice and legal directives are two means available.
Overall the need for a better based end of life care strategy is warranted globally. More of a focus should be given on care and high quality service for patients. As of now too much decision lies with the healthcare professionals and this can lead to faulty decision making because the health care providers are doing what they believe is in our best interest. In reality the patient or ourselves only have the true idea how we would like our final days to be carried out. By developing and carrying out an end of care plan we can take the decision making out of the family and doctors and place it on the patient. By all counts the need for change is apparent within the healthcare industry in regards to end of life care. By considering this unique change a great deal of improvement can be derived from this decision making process.
The concept between life and death cannot simply exist without one another, where the topic is widely discussed throughout “When Breath Becomes Air” by Paul Kalanithi. This memoir explores Paul’s definition of death as he passes through the distinct “stages” of his life. As Paul progresses through each stage, he views death differently as he transformed from a student to a neurosurgeon, neurosurgeon to a patient, and eventually becoming a father, where he needed to take full responsibility as an adult.
The subject of death and dying is a common occurrence in the health care field. There are many factors involved in the care of a dying patient and various phases the patient, loved ones and even the healthcare professional may go through. There are many controversies in health care related to death, however much of it roots from peoples’ attitudes towards it. Everyone handles death differently; each person has a right to their own opinions and coping mechanisms. Health care professionals are very important during death related situations; as they are a great source of support for a patient and their loved ones. It is essential that health care professionals give ethical, legal and honest care to their patients, regardless of the situation.