Tuesday, September 23, 2008

Inside Medicine: Doctors torn by end-of-life philosophies

Doctors and the American public are afraid to let people die – and even help them do so – with comfort and dignity.

That has become clear to me over my 20 years of practice and through the stories that my colleagues have shared with me.

One doctor e-mailed me about his patient, a woman of 80, who found herself dying of emphysema. Despite being tethered to green oxygen cylinders and having her face constantly enmeshed in clear plastic face masks, she was continually short of breath.

Talking was very difficult and walking even short distances was out of the question. Faced with a terminal illness, she chose hospice care rather than spend her last days in a hospital.

She asked for a pill to end her life. The doctor told her she was depressed (which, given her situation, she might well have been). He offered antidepressant medications. She refused – "no more treatments."


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