A nightmare that doctors overwhelmingly choose to avoid when they die themselves

[Carolina]

116. as a doctor

I have found this to be true. We know the truly life saving wonders of modern medicine and medical technology as well as the the fact that both can sometimes save physical existence only.

Accordingly, we choose palliation and death for ourselves. And we tell everyone we know in advance, do very specific advanced directives and put legal teeth in our wishes by designating a health care power of attorney. That way, there is no question, no doubt and the POA can carry out our wishes without hesitationt or recrimination.

While some on this thread suggest it's for profitability of the hospitals or a result of MDs pushing any/everything, the truth is it's families and the litigious nature of medical practice. Doctors shake their heads at the wastefulness but proceed because families have never had the discussion and patients have not done advanced directives. (BTW, you're never too young to have one; just consider terry Schiavo). For instance, telling a doctor to "do what you can" in an elderly patient with multiple co-morbidities may sound innocuous but it spirals from the initial workup: history, physical, labs (CMP, U/A), X-rays (chest for starters) to specifics (e.g head CT) based on findings and on and on... until suddenly the patient is on a vent in ICU because of those findings and both the MDs and the families are caught in this awful cycle.

Hearing of the occasional miracle or watching the unrealistic outcomes on TV, some families will push the MDs to do everything. But once someone is on a ventilator or worse, has had a feeding tube placed, removal opens up a legal Pandora's box.

Believe me, doctors know when it's a hopeless situation and would prefer to do less, but they can only make such a definitive decision about our own mortal bodies. They cannot decide to deny or withhold care if a patient has not made such wishes known through certified LEGAL documents or if the family opts for that spiralling "do what you can..."