DON’T Euthanate – PALLIATE !!!

It is no wonder so many terminally ill patients are begging for euthanasia. The vast majority of terminally ill patients are seldom offered a “purely palliative approach” (comfort measures only).  Instead, patients are being paternalistically forced to adopt futile medical micromanagement until their last breath. Where is the patient-centeredness in this equation? While dying patients are getting their hemoglobins, serum potassiums, and serum rhubarbs treated, there is negligible regard for the suffering they are experiencing. Available research shows NO survival benefit in continuing Active/Aggressive Medical Micromanagement (AAMM) over a purely palliative approach in late stage patients (PPS<50%). All the “fluffing and buffing” of such patients is not in the best interest of the patient, families or the health care system. Unfortunately, most physicians find it easier to simply continue with futile “fluffing and buffing” instead of having  fulsome discussions about natural history of disease, prognosis, and effectiveness/efficacy and burden of those AAMM treatments. It behooves physicians to thoroughly discuss these foundational issues with patients in order to allow them to choose the direction/philosophy of care that is consistent with their own preferences, values, beliefs, and wishes. Available research shows that if such patients are given a choice, the majority would choose a purely palliative approach (comfort measures only), while withholding continued AAMM. Such a truly patient-centered approach will lead to fewer requests for euthanasia.

About drvincentmaida

Consultant in Palliative Medicine & Wound Management, Assistant Professor, University of Toronto & McMaster University, Researcher & Author.
This entry was posted in Bioethics, Distributive Justice, Palliative Medicine, Promoting PCC & PE. Bookmark the permalink.

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