The medical field is designed to save lives and this article “No Risky Chances,” by Author Atul Gawande’s published in the online magazine Slate, reminds medical professionals one very important thing that there is no risky chances my determining treatment options, professionals need to consider options, professionals need to consider options, professionals need to consider options that are aligned with the patients personal choice which can range from maintaining life by any means necessary to continued comfort until death. Either way it is important for medical staff to be trained not only in saving life’s but also in preparing for patient death. It is a very difficult decision on whether or not to proceed with a medical procedures when
The facts in this case involve 2 patients. Firstly, Marguerite, an 89 year old female who experienced a myocardial infarction and the cause was unknown at the time of admission. Her doctor ordered an angiogram to test for the cause, and based on the results, would plan and provide treatment. On the other hand, Sarah, a 45 year old female, also experienced a massive heart attack, but in her case the emergency room doctors were able to determine the cause and expeditiously planned for treatment. Simultaneously, both patients required an immediate surgical procedure and time was a major consideration due to the nature of their
“In quixotically trying to conquer death doctors all too frequently do no good for their patients’ “ease” but at the same time they do harm instead by prolonguing and even magnifying patients’ dis-ease.”
The repetition of “perhaps” only epitomizes the inability to move on from making a mistake. However, this repetitive language also demonstrates the ends a doctor will meet to save a patient’s life (73). Therefore, it is not the doctor, but the medicine itself that can be seen as the gateway from life to death or vice versa. Although the limitations of medicine can allow for the death of a patient to occur, a doctor will still experience emotional turmoil after losing someone he was trying to help. Throughout the collection of essays, the author demonstrates with personal experiences and outside sources that a physician does not ponder about his mistake for long.
A divergent set of issues and opinions involving medical care for the very seriously ill patient have dogged the bioethics community for decades. While sophisticated medical technology has allowed people to live longer, it has also caused protracted death, most often to the severe detriment of individuals and their families. Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center, believes too many Americans are “dying badly.” In discussing this issue, he stated, “Families cannot imagine there could be anything worse than their loved one dying, but in fact, there are things worse.” “It’s having someone you love…suffering, dying connected to machines” (CBS News, 2014). In the not distant past, the knowledge, skills, and technology were simply not available to cure, much less prolong the deaths of gravely ill people. In addition to the ethical and moral dilemmas this presents, the costs of intensive treatment often do not realize appreciable benefits. However, cost alone should not determine when care becomes “futile” as this veers medicine into an even more dangerous ethical quagmire. While preserving life with the best possible care is always good medicine, the suffering and protracted deaths caused from the continued use of futile measures benefits no one. For this reason, the determination of futility should be a joint decision between the physician, the patient, and his or her surrogate.
Patients are ultimately responsible for their own health and wellbeing and should be held responsible for the consequences of their decisions and actions. All people have the right to refuse treatment even where refusal may result in harm to themselves or in their own death and providers are legally bound to respect their decision. If patients cannot decide for themselves, but have previously decided to refuse treatment while still competent, their decision is legally binding. Where a patient's views are not known, the doctor has a responsibility to make a decision, but should consult other healthcare professionals and people close to the patient.
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
have to make decisions that are needed at that moment. Not only is the patient the focus but
The choice to treat appendicitis with antibiotics instead of removing the organ all together could very easily result in a patient’s passing. This idea alone is what troubles people when doctors work off of a hunch. Without concrete facts to back up their ideas, what would happen if they were wrong? Physicians are given access to some of the most modern technology in the world, so mistakes are not taken lightly; nonetheless, they still happen. Yet there are cases where a doctor’s intuition is wrong, but their plan works. Gawande speaks of a patient, Lee Tran, who had a tumor obstructing his airways and needed immediate aid. His team of doctors had only one idea: put in a catheter to drain the fluid from the tumor, in the hopes it would shift and open the airway to Tran’s left lung: a high-risk procedure. “It was little more than a guess about what to do - a stab in the dark, almost literally. We had no backup plan should disaster have occurred.” (p.7) The doctors were fortunate that day, and not only was the path to the left lung completely opened, so was the right’s. Lee survived. However, what would have happened had the outcome not been so favored? Gawande wrote that after he did research on similar cases, he found there was another option; a safer option. For the most part Gawande’s oversight is forgivable. Doctors are allowed to make mistakes; after all, humans are prone to error. But at what point does it turn from “following your gut” to actual negligence? There is a grey area between the two, and more often than not, a doctor’s unconscious choices are more at fault than their conscious ones. On this Gawande remarks: “In most cases it wasn’t technology that failed. Rather, the physicians did not consider the correct diagnosis in the first place. The perfect test or scan may have been available, but the physician never ordered it.” (p. 198) Humans are fallible, but in the healthcare
Discussion between the physician and the patient regarding treatment options and the risks and benefits of treatment.
Critics to the idea of providing dying patients with lethal doses, fear that people will use this type those and kill others, “lack of supervision over the use of lethal drugs…risk that the drugs might be used for some other purpose”(Young 45). Young explains that another debate that has been going on within this issue is the distinction between killings patients and allowing them die. What people don’t understand is that it is not considered killing a patient if it’s the option they wished for. “If a dying patient requests help with dying because… he is … in intolerable burden, he should be benefited by a physician assisting him to die”(Young 119). Patients who are suffering from diseases that have no cure should be given the option to decide the timing and manner of their own death. Young explains that patients who are unlikely to benefit from the discovery of a cure, or with incurable medical conditions are individuals who should have access to either euthanasia or assisted suicide. Advocates agreeing to this method do understand that choosing death is a very serious matter, which is why it should not be settled in a moment. Therefore, if a patient and physician agree that a life must end and it has been discussed, and agreed, young concludes, “ if a patient asks his physician to end his life, that constitutes a request for
As a result, life-sustaining procedures such as ventilators, feeding tubes, and treatments for infectious and terminal diseases are developing. While these life-sustaining methods have positively influenced modern medicine, they also inadvertently cause terminal patients extensive pain and suffering. Previous to the development of life-sustaining procedures, many people died in the care of their own home, however, today the majority of Americans take their last breath lying in a hospital bed. As the advancement of modern medicine continues, physicians and patients are going to encounter life-altering trials and tribulations. Arguably, the most controversial debate in modern medicine is the discussion of the ethical choice for physician-assisted suicide.
“I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.”
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.
Balabhai Nanavati Hospital. The number of deaths which occur in the ICU after withdrawal of life support is increasing with one survey finding that 90 % of patients who die in the hospital do so after a decision to limit therapy. The goal of a physician has to be enlarged to include assuring the patient of a “good death” Developments in technology now make it possible for almost all patients to have a death that is dignified and free from pain. Palliative care and intensive care are not mutually exclusive options but are rather coexistent. Intensive care clinicians must be as skilled and knowledgeable at forgoing life-sustaining treatments as they are at delivering care aimed at survival and cure.
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.