The best reading ever regarding end of life!
Everything you always wanted to know about end of life but were afraid to ask!
Our interest is: read, read, read this 13-page-essay:
Once again, the author of "Complications", "Better", "The checklist manifesto" wrote a first-class essay on a sensitive subject. For the broad public, physicians, nurse practitioners, nurses, your and my GP, etc. On behalf of all of them (including myself): thank you, Dr. Gawande!
"The difference between standard medical care and hospice is not the difference between treating and doing nothing, (...) [the nurse practitioner] explained. The difference was in your priorities. In ordinary medicine, the goal is to extend life. We’ll sacrifice the quality of your existence now — by performing surgery, providing chemotherapy, putting you in intensive care — for the chance of gaining time later. Hospice deploys nurses, doctors, and social workers to help people with a fatal illness have the fullest possible lives right now. That means focussing on objectives like freedom from pain and discomfort, or maintaining mental awareness for as long as possible, or getting out with family once in a while. Hospice and palliative-care specialists aren’t much concerned about whether that makes people’s lives longer or shorter.
Like many people, I had believed that hospice care hastens death, because patients forgo hospital treatments and are allowed high-dose narcotics to combat pain. But studies suggest otherwise. In one, researchers followed 4,493 Medicare patients with either terminal cancer or congestive heart failure. They found no difference in survival time between hospice and non-hospice patients with breast cancer, prostate cancer, and colon cancer. Curiously, hospice care seemed to extend survival for some patients; those with pancreatic cancer gained an average of three weeks, those with lung cancer gained six weeks, and those with congestive heart failure gained three months. The lesson seems almost Zen: you live longer only when you stop trying to live longer."
("Letting go", The New Yorker, June 2010, page 4)
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