End of Life Conversations: From A Doctor’s Perspective

My wife Janet shared with me a very moving article about end of life conversations from a doctor’s perspective entitled: Talking Frankly at the End of Life. Here is the link.

One of the most important aspects of the article is the issue of telling the patient the truth about their medical condition. “Am I doing more harm than good?” the author asks from her physician point of view. She cites a recent study in JAMA that asked 300 terminal patients “if their doctors had ever discussed care at the end of life.” As important, after the patients died, the researchers looked at the type of care the patients received prior to death and then interviewed the caregivers six months after the death to see how they were adjusting.

The results indicated that the patients who discussed care at the end of life were more likely to have a better quality of life at the end of their lives. They were not more depressed. They had less aggressive medical interventions. They went to hospice earlier. As important, their caregivers fared better.

What we want to know at the end our life is a personal choice. We all want some version of the truth but in different degrees and different doses. The key is being offered, more than once, the opportunity to hear it from the person who holds so much sway over our lives: the doctor. It is a natural part of our leaving, the slow dance we all take to step away from this life, preserving our dignity and saying our final goodbyes. Ironically, to do this we may need to remind the doctors who take care of our aging parents as well as ourselves, it’s okay to talk about the end, more than once…