Issue 26.15
One of those subjects patients have a hard time talking about is end of life wishes. The worst time to be having this conversation is when you are suddenly taking a significant down turn with being sick, severely ill, or having a medical emergency. Even worse is if you are impaired enough that you are not capable of making that decision and it is being left to family, friends or others.
I often find when a loved one is sick, the emotional distress and anxiety that comes with this may cause those making the decision to be short-sided, thinking more of their concern of losing a loved one rather than the trauma that may come from doing more aggressive interventions or life sustaining treatments. If someone’s health is that poor or deteriorated, just because we can do something doesn’t always mean we should. Sometimes, the bigger fail, isn’t not being able to save or treat those who can be treated. It is treating someone aggressively with life sustaining measures when they wouldn’t want it.
As a physician, I feel devastated when a patient is “saved” to end up living without any quality of life and they ask me, “Why didn’t you just let me go when I was sick and dying?” For many people, there are worse things than dying.
I encourage everyone to have a Physician Order for Life Sustaining Therapy (POLST) form filled out. A living will is not enough and not specific where as a POLST form is. Having this filled out and making sure your family and friends and primary care provider are aware of your wishes is the best way to make sure that YOUR wishes are being followed.
Karen Radley, MD is a family physician who can help with this.
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