Two back to back blog posts in my RSS reader, and they are both on the same wavelength: there’s a time when doing everything is right, and a time when it’s wrong.
Charity Doc with Why?
Panda Bear, MD with Obels for Charon.
Recommended.
1 thought on “Do Everything theme day”
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Been there, done all of that, and in the olden days, had an ENT onc. surgeon refuse not to code patients because he “didn’t believe in not giving them a chance.” Ye gads and little fishes.
There’s a third way to approach these conversations, just as some more food for thought. When you’re heading into them without having a prior relationship with the patient/family, you can lead the conversation with the statement that they are already in the process of dying. That changes the conversation from “cure” into palliation and comfort as the measures to be offered and discussed. You certainly can “do everything” as long as it’s everything toward comfort and assisting in a peaceful death.
You can also be blunt about the message that “doing everything” will only cause pain and suffering, and it will not stop the dying.
I had a family member who repeatedly insisted that we “do everything”, and we as a team repeated that we could not stop the dying. He finally got it and helped us in determining appropriate comfort measures.
Part of this “do everything” reaction is the sense of surrealness that overtakes people in crisis. Since they feel powerless and paralyzed, they are at least able to call out for help – “do everything” – since they are unable to.
Our job is to repeat reality “the person is already dying” and to offer the lifeline – “how do you want us to keep him comfortable?”
Thanks for posting this, GruntDoc.