A friend (thanks, Roger!) passed along this NY Times article to me the other day week. It made me think about the physician’s role in end-of-life care. More specifically, it made me evaluate my position on end-of-life care and the type of physician I will become.

While there are universally accepted protocols for treating conditions like flu and diabetes, this is not as true for the management of people’s last weeks, days and hours. Indeed, a review of a decade of medical literature on terminal sedation and interviews with palliative care doctors suggest that there is less than unanimity on which drugs are appropriate to use or even on the precise definition of terminal sedation.

Discussions between doctors and dying patients’ families can be spare, even cryptic. In half a dozen end-of-life consultations attended by a reporter over the last year, even the most forthright doctors and nurses did little more than hint at what the drugs could do. Afterward, some families said they were surprised their loved ones died so quickly, and wondered if the drugs had played a role.

Whether the patients would have lived a few days longer is one of the more prickly unknowns in palliative medicine. Still, most families felt they and the doctors had done the right thing.

~ from the NY Times

The entire article is moving and worth a read. I found it intriguing because I really like dealing with old people in medicine. And I feel drawn to some of the harder specialties like oncology and palliative care.

As such, it is inevitable that the ethics of pain management and medication in end-of-life care have a few lessons up their sleeves for me. I intend to learn a lot from patients and their families on how they want to spend their final days.

Because when the time comes, I hope someone is listening to me.

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