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Posted: October 27th, 2023
How do doctors and patients decide when to stop treatment for terminal illnesses? (Intermediate)
Terminal illnesses are diseases that cannot be cured and will eventually lead to death. Patients with terminal illnesses face difficult decisions about whether to continue or stop treatment that may prolong their lives but also cause side effects and suffering. Doctors have the responsibility to inform patients about their diagnosis, prognosis, and treatment options, and to respect their preferences and values. However, communication and decision making about end-of-life care can be challenging for both doctors and patients.
Some factors that may influence the decision to stop treatment for terminal illnesses are:
– The patient’s goals and expectations of treatment. Some patients may want to pursue aggressive treatment until the end, hoping for a miracle or a breakthrough. Others may prefer to focus on quality of life and comfort, and avoid interventions that may cause more harm than good [1].
– The patient’s understanding of their condition and prognosis. Patients have the right to know that they are terminally ill and what that means for their future. However, some patients may not want to know or may have difficulty accepting the reality of their situation. Doctors need to communicate clearly and sensitively with patients, and provide them with accurate and honest information [2].
– The patient’s values and beliefs. Patients may have different views on what makes life worth living, what constitutes a good death, and what happens after death. These views may be influenced by their culture, religion, spirituality, or personal experiences. Doctors need to respect the patient’s values and beliefs, and support them in making decisions that are consistent with their wishes [3].
– The patient’s family and social support. Patients may consider the impact of their decisions on their loved ones, such as their spouse, children, friends, or caregivers. They may want to involve them in the decision making process, or delegate the decision to them if they are unable or unwilling to decide for themselves. Doctors need to facilitate family involvement and communication, and address any conflicts or disagreements that may arise [4].
Deciding when to stop treatment for terminal illnesses is not easy. It requires a balance between hope and realism, autonomy and guidance, benefit and burden. Doctors and patients need to work together to find the best course of action for each individual case.
References:
[1] Writing and Teaching With a Terminal Illness – The Chronicle of Higher Education https://www.chronicle.com/article/writing-and-teaching-with-a-terminal-illness/
[2] Do patients need to know they are terminally ill? Yes | The BMJ https://www.bmj.com/content/346/bmj.f2589
[3] Terminal Illness | SpringerLink https://link.springer.com/referenceworkentry/10.1007/978-0-387-79061-9_2889
[4] End-of-Life Decisions: How Do We Choose for Those Who Cannot Choose … https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928735/
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