There were 2, deceased physicians, 2, lawyers, and , from the general population included in the analysis. Physicians were less likely to die in a hospital compared to lawyers Investigators note that additional research is needed to explore how complex decision-making processes and satisfaction with end-of-life care are related to these findings, and to see if the results found in this analysis will hold true in other states once data becomes available.
Campus Alert. Returning to Campus. Gallo and his team recently submitted a grant application to the National Institute of Nursing Research, part of the NIH, to conduct a mixed-methods study with the surviving physicians in the Precursors Study group.
In addition to the questionnaire, the researchers hope to perform some telephone sampling in which they ask open-ended questions. Murray K. Accessed April 25, Why doctors die differently. Wall Street Journal. February 25, Accessed April 20 , Meanwhile, terminally ill patients were assumed to choose hospitalization overestimating the benefits of healthcare in a hospital setting. It was also thought that doctors might have a higher acceptance of mortality due to their familiarity with death and dying in their profession than those patients who were not as familiar.
In recent years, there have been numerous essays and articles written by doctors that have been focused on by the general media on the idea that doctors are forgoing aggressive care in favor of the quality of life. One would tend to think that doctors, with their extensive knowledge of modern medicine and the choices that go along with them including being in a position to have access to any sort of medical care they want, would choose any care that would sustain life.
Instead, according to Dr. Having far more first-hand knowledge of unnecessary tests, operations, and treatments than terminally ill patients nearing the end of life, doctors realize the futility of such treatments but perform them anyway for fear of litigation of working within a health-care system that encourages excessive treatment even when the risks outweighs the benefits.
Oftentimes, excessive tests, and surgeries in intensive care units alone cost the patient more than than they could afford and what insurance will pay. Then the nightmare begins. The above scenario is a common one. Feeding into the problem are unrealistic expectations of what doctors can accomplish.
Many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor. If a patient suffers from severe illness, old age, or a terminal disease, the odds of a good outcome from CPR are infinitesimal, while the odds of suffering are overwhelming. Poor knowledge and misguided expectations lead to a lot of bad decisions.
Doctors play an enabling role, too. The trouble is that even doctors who hate to administer futile care must find a way to address the wishes of patients and families. Imagine, once again, the emergency room with those grieving, possibly hysterical, family members.
They do not know the doctor. Establishing trust and confidence under such circumstances is a very delicate thing. People are prepared to think the doctor is acting out of base motives, trying to save time, or money, or effort, especially if the doctor is advising against further treatment. Some doctors are stronger communicators than others, and some doctors are more adamant, but the pressures they all face are similar.
When I faced circumstances involving end-of-life choices, I adopted the approach of laying out only the options that I thought were reasonable as I would in any situation as early in the process as possible.
If patients or families still insisted on treatments I considered pointless or harmful, I would offer to transfer their care to another doctor or hospital. Should I have been more forceful at times? I know that some of those transfers still haunt me. One of the patients of whom I was most fond was an attorney from a famous political family.
She had severe diabetes and terrible circulation, and, at one point, she developed a painful sore on her foot. Knowing the hazards of hospitals, I did everything I could to keep her from resorting to surgery. Still, she sought out outside experts with whom I had no relationship. Not knowing as much about her as I did, they decided to perform bypass surgery on her chronically clogged blood vessels in both legs.
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