Comments on: Medical Conservatism and End-of-life Decisions

By: Who Should Decide What Medical Treatments We Receive? | Medical Insurance

Who Should Decide What Medical Treatments We Receive? | Medical Insurance — Mon, 12 Jul 2010 15:09:24 +0000

[...] who should be making our medical decisions. It’s easy to just say that we should be making the decisions between ourselves and our doctors. [...]

By: Mary John

Mary John — Tue, 22 Jun 2010 13:14:17 +0000

In the death-certificate study, 57% of all deaths had been preceded by a decision to forgo life-sustaining treatment; this decision was accompanied by the administration of potentially life-shortening drugs to alleviate pain or other symptoms in 23%, and by the administration of drugs with the explicit aim of hastening death in 8%. A drug was given explicitly to hasten death to neonates not dependent on life-sustaining treatment in 1% of all death cases. No chance of survival was the main motive in 76% of all end-of-life decisions, and a poor prognosis was the main motive in 18%. The interview study showed that parents had been involved in making 79% of decisions. The physicians consulted colleagues about 88% of decisions. Most paediatricians favoured formal review of medical decisions by colleagues together with ethical or legal experts.

By: MKG

MKG — Sun, 20 Jun 2010 16:54:14 +0000

I think it comes down to the patient to really request and demand the information from their physician about pros/cons/alternatives and take a stand on how they want to be treated at the end of their life. Is the reason that patients are responding to the polls, indicating that they aren’t getting all the pros and cons really the physicians problem? I don’t think we can blame it all on the physicians. No matter what, there will probably always be financial incentives to provide care and more of it than necessary, it’s what they do, and it’s how they get paid. Is that why the Doctors aren’t telling their patients about the alternatives and giving them the full pros and cons? I hope not. I hope that they are at least thinking that they are more qualified to make the correct decision, either way, I don’t agree with either the doctors thinking they are in the position to make decision for the patients, especially if there are financial incentives for them. The only way i would think to get around this over treatment would be to shift the financial incentives to other aspects of healthcare, specifically not over treating. Healthcare is a business, maybe Medicare needs to change the way it reimburses physicians for end-of-life care. Overall, something needs to be done about it.