Why Do End of Life Decisions Differ Between Physicians and Their Patients?

Doctors, it turns out, overwhelmingly say no to invasive testing, chemotherapy and chest thumping CPR.  An article recently published on Pacific Standard  is worth considering when making choices on your Advance Directive for Health Care – your end-of-life decisions.

When you ask people how they’d like to die, most will say that they want to die quickly, painlessly, and peacefully—preferably in their sleep.

But if you ask them whether they would want various types of interventions were they on the cusp of death and already living a low-quality of life, they typically say “yes,” “yes,” and “can I have some more please.” Blood transfusions, feeding tubes, invasive testing, chemotherapy, dialysis, ventilation, and chest pumping CPR. Most people say “yes.”

But not physicians. Doctors, it turns out, overwhelmingly say “no.” The graph below shows the answers that physicians give when asked if they would want various interventions at the bitter end. The only intervention that doctors overwhelmingly want is pain medication. In no other case do even 20 percent of the physicians say “yes.”

 

Photo Credit: www.psmag.com

 

The article goes on to give a few reasons why physicians differ on this topic.  Here is the first reason.

What explains the difference between physician and non-physician responses to these types of questions? University of Southern California professor and family medicine doctor Ken Murray gives us a couple of clues.

First, few non-physicians actually understand how terrible undergoing these interventions can be. He discusses ventilation. When a patient is put on a breathing machine, he explains, their own breathing rhythm will clash with the forced rhythm of the machine, creating the feeling that they can’t breath. So they will uncontrollably fight the machine. The only way to keep someone on a ventilator is to paralyze them. Literally. They are fully conscious, but cannot move or communicate. This is the kind of torture, Murray suggests, that we wouldn’t impose on a terrorist. But that’s what it means to be put on a ventilator.

You may read the entire article here: Why Is the Way Physicians Want to Die So Different From the Rest of Us?

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