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View Diary: Why End of Life Counseling is Imperative (256 comments)

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  •  It's a quality of care issue, not rationing. (3+ / 0-)
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    Brooke In Seattle, mayim, dark daze

    Many intensive care technologies such as ventilators and defibrillators were developed with very specific goals in mind. They were intended to support patients over a temporary illness, or to abort a transient but lethal heart rhythm disturbance. They were not developed with the goal of prolonging the dying process for patients who are terminally ill; yet that's how they are used routinely, every single day.

    As a physician it's incredibly discouraging to see a terminally ill 85 year old with cancer or end-stage emphysema suffering on a ventilator in the ICU. We end up tormenting these poor souls for days or weeks, knowing full well they will never leave the hospital, just because they never executed advanced directives (or health care proxy, or living will, or whatever it's called in your state), and the conflicted family can't agree that it's time to stop.

    We really need to kill the notion that end of life care discussions are about rationing or reducing costs. This is one of the most pernicious and dishonest notions ever floated by the wingnuts. Instead it's all about letting us know what you want for your own care, about getting the very best quality end-of-life care possible.

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