Terminal Illness – Should we fight to the bitter end? If not what to do?
100 years ago, most deaths were quick. A person was well and then sick and then dead. Medicine could do very little. But today, most of us die long protracted deaths. Treatment is piled upon treatment. The dying person and their families endure increasing pain and humiliation and disappointment. Often what has been really extended is more suffering. The problem is that our culture and the advances of medicine give us false hope in many cases. We cannot let go.
Hospice has been on offer for many years. But many feel that taking hospice is giving up.
The irony is that it is not. What it offers is a better quality of life for the terminally ill and for their families.
This is still a controversial issue for many people. To help you learn more here is an outstanding post in the New Yorker by By Atul Gawande
A snippet here:
Wasn’t the goal of hospice to let nature take its course?
“That’s not the goal,” Creed said. The difference between standard medical care and hospice is not the difference between treating and doing nothing, she explained. The difference was in your priorities. In ordinary medicine, the goal is to extend life. We’ll sacrifice the quality of your existence now—by performing surgery, providing chemotherapy, putting you in intensive care—for the chance of gaining time later. Hospice deploys nurses, doctors, and social workers to help people with a fatal illness have the fullest possible lives right now. That means focussing on objectives like freedom from pain and discomfort, or maintaining mental awareness for as long as possible, or getting out with family once in a while. Hospice and palliative-care specialists aren’t much concerned about whether that makes people’s lives longer or shorter.
Like many people, I had believed that hospice care hastens death, because patients forgo hospital treatments and are allowed high-dose narcotics to combat pain. But studies suggest otherwise. In one, researchers followed 4,493 Medicare patients with either terminal cancer or congestive heart failure. They found no difference in survival time between hospice and non-hospice patients with breast cancer, prostate cancer, and colon cancer. Curiously, hospice care seemed to extend survival for some patients; those with pancreatic cancer gained an average of three weeks, those with lung cancer gained six weeks, and those with congestive heart failure gained three months. The lesson seems almost Zen: you live longer only when you stop trying to live longer. When Cox was transferred to hospice care, her doctors thought that she wouldn’t live much longer than a few weeks. With the supportive hospice therapy she received, she had already lived for a year.
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