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Forgoing Medical Treatment |
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 Introduction
Many people say that they do not not want to be tied to machines at
the end of life, but how does one get "just the right amount" of treatment?
Many treatments are started because there is still some real chance
that the patient will improve. Even if everyone thinks the patient
is dying, some treatments may be started in hopes of improving comfort.
So artificial life support may become an issue for discussion or decision,
even if you have plans not to use such treatments when you are "terminal"
or the situation is "hopeless."
Artificial nutrition ("tube feeding"),
intravenous (IV) hydration, antibiotics,
and breathing machines (ventilation)
are usually put in place because there is the expectation, or the
hope, that a patient is going to recover from a temporary setback.
Deciding to use these treatments in the course of a serious, chronic
illness demands careful consideration. Once treatments have begun,
it can be hard to decide to stop. You and your family need to know
that you can stop treatment whenever you firmly decide to do so. Here's
an approach to thinking about the issues.
You need to know what it will accomplish and what burdens it will
cause. You often will want to try it out before deciding that it is
not "worth it" for you. This holds true for simple treatments like
antibiotics or insulin, for routine treatments like tube feeding,
and for dramatic treatments like ventilators and chemotherapy. The
principles are the same, and the need for a compassionate and knowledgeable
doctor is also constant. |
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Adapted from The
Handbook for Mortals: Guidance for People Facing Serious Illness,
by Joanne Lynn and Joan Harrold, copyright by Joanne Lynn, used by
permission of Oxford University Press.
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