[jIM_Ohio]

Originally Posted by asmom

Scanner, I couldn't get the video to load but could you elaborate on your comments about the system? Let me just say that having been an RN for over 18 years, I have been a witness to end of life decisions more than I can count and there are often two scenarios:

1) Physicians are not really clear about the patient's chances of recovery. They are human too and some of them are more comfortable discussing death than others. I've seen some of them dance around direct questions from patients and questions or speak in such technical terms about chances that they are left with a false hope or understanding, leading to prolonged and futile treatment.

2) (most common) The family is not prepared to accept the end of their loved ones life or they are too afraid to take a stand and let them go lest they be labeled as "letting Mama die". The patients themselves are often matter of fact about facing their end, some write living wills, some won't but very few want to end their lives in the ICU hooked to the vent. How many times have we seen the patient and family agree to let Mama die a peaceful, natural death only for cousin Sally from Des Moines to fly in and insist that everything be done or they will sue the pants off the hospital, doctors and the janitors? The family then allows themselves to be bullied into revoking the DNR or living will or whatever. That happens more times than I can count and it's a crying shame. That's not a system problem.


There is a big movement around hospice and palliative care. There needs to a lot more education about it but the foolishness we witnessed this summer with death panels and such caused us to be extremely sensitive about how we approach people about this issue. We always tell people, it is not enough to have a living will you have to tell everyone how you feel and say it like you mean it.

excellent post