|Source: Zócalo Public Square|
Many physicians would not subject themselves to aggressive end of life treatments. They treat themselves differently than patients, preferring to die peacefully at home or in hospice. Patients often receive aggressive and futile end of life care, frequently in an intensive care unit.
The reasons for these differences are multiple and are explored in the Dr. Murray's essay. The system can victimize a patient at the end of life as medical decision making is driven by:
- unrealistic patient expectations (heroic 'saves' of patients, as seen on TV) despite a physician's understanding of the limitations of end of life care
- fear of litigation
- a fee for service medical system that rewards physicians and healthcare centers for more care with additional reimbursement
- physician coping mechanisms for end of life issues (previously discussed on this blog)
As a profession we should strive to thoroughly make clear the limitations of aggressive end of life treatments and resuscitation. This should result in less doctor-patient information asymmetry and more reasonable decision making during end of life care.