‘Unwanted treatment’ view right, but not easy to implement

August 19, 2013 

View right, but not easy

I am in full agreement with [the July 30 Take a View] “Unwanted Treatment …”

However, it’s easy to talk about it but not easy to implement.

After a total of 47 years in medicine, which included 30 years as a solo family physician, I feel qualified to make a few comments.

As with any physician dealing with end of life care, there must be total, reciprocal exchange of information between the physician, the patient and the family.

My plan was as follows:

• As the inevitable moment of death is approaching, the in-charge physician approaches all the consultant physicians to elicit information and ask “is there anything else you can do to reasonably survive this patient?”

If nothing further can be done, then it is time to meet with the family to explain everything, and to say, what is so hard to say, namely, “OK, no further treatment, just supportive care from this point on.”

This approach never failed me.

Now there are aspects to this approach, which cannot be touched upon due to lack of space. Namely:

1. Individual physician ability/talent to face this terrible event.

2. The physician’s nightmare, namely, the legal system wherein “one more CT Scan will protect us.”

3. The occasional, emotional family member who cannot let go and demands further treatment.

MICHAEL J. McCARTHY

M.D. FAAP (Ret.)

Lake Wylie

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