This is a very good article that discusses the important of physicians having the much needed discussion about end of life and dying with their patients.
“There is no “right” answer for how patients should respond to a terminal illness. It’s a deeply personal decision based on a complex array of spiritual, social, financial and emotional needs.” BUT- physician or other healthcare professionals.”
Patients who are terminal can only make these tough choices if their doctor (s) are trained and able to share bad news. Yet many doctors receive zero training on how to have these hard conversations and less than a third of primary care physicians receive instruction in end-of-life treatment.
Fortunately, some medicals schools have noticed this training gap and are evolving their curricula to fill it. Stanford’s medical school orientation now includes a discussion of the ethics of death. George Washington University Medical School offers a full course about dying.
Johns Hopkins goes a step further and actually assigns students to write instructions for their own end-of-life care, an exercise that forces them to confront the difficult decisions terminal patients face.
That to me is interesting as what better way to have a discussion about a taboo or fearful topic is to think about and write out what you would do or choose.
In my head I have had this conversation with myself many times and I think I know what I would choose if I was ever in that situation of being diagnosed with a terminal illness. Not long ago a friend and I were talking about a person who was diagnosed with breast cancer. We each had different reactions to this news and answers as what we would do regarding treatment.
For me, depending on if it was localized (1 spot) or not; meaning it had spread-I would seek the least invasive treatment. Chemo to me is a last choice and only if it has a good chance of making a difference. From what I have been exposed to both personally and professionally-chemo has a negative effect on the person with cancer and causes other health issues along with destroying all the good things about you physically. It is poison!
I would seek a healthy diet, exercise, alternative therapies to assist with symptoms and pain and would want to spend as much quality time as possible with my family and friends vs. in a hospital receiving chemo and being sick daily afterwards. Where is the quality of life in that? But this is me and my choice. Others may and have chosen differently. That is what makes us unique. This is why the medical team from the physician to the nurse to the social worker and other medical personnel need to be trained to have discussions about the disease, illness, treatment options and be prepared to talk.
And honestly, unless we are going through this ourselves-we can listen, discuss all the options, be empathic and supportive, but ultimately it should be the patient who make the decision regarding treatment or not.
NorthernMSW: Advocacy, Education/Guidance on Grief 