Saturday, November 26, 2011

What Do You Know About End of Life, Doctor?

Thaddeus Pope highlights questions 26 and 27 from a recent Regence Foundation poll, "Living Well at the End of Life." Pope keeps a blog about futile care (that you should all read) so the two questions he highlights, below, specifically address removal from curative treatment.

A few other interesting points come out in the poll as well: most patients are ill informed about end of life and palliative care options; patients and their families are more concerned with cost than doctors; and if I'm reading the poll correctly, doctors in Oregon and Washington, states where a state-wide discussion about end of life options has been had -- Death with Dignity laws are in place in both -- agree that quality of life is more important than length of life. Then there's the District of Columbia. 96% of doctors there agreed (compared to 71% nationally, and 85% and 83% in Oregon and Washington respectively).

Another series of questions worth looking at are 29, 30 and 31. Practitioners admit that their education and residencies gave them less exposure to end of life issues than did their practice. Read the entire poll findings here.

26. From your experience, how often do patients and their families reject your recommendation to discontinue curative treatment in favor of palliative care?
66% Regularly / Occasionally
34% Infrequently / Never

27. What reasons have patients and their families given for rejecting your recommendation to discontinue curative treatment in favor of palliative care?
75% Unwillingness to accept that curative treatment was ineffective
74% Disagreement from family members about discontinuing curative treatment
63% Preference for more aggressive curative treatment options
42% Religious hesitations or objections
37% Disagreement with the diagnosis or wanted a second opinion
1% Other

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