Quality vs. quantity
By Jaime
April 5, 2010
We as a society do not like talking about death and dying; those of us in medicine are no different. Death is seen all too commonly as a failure. We talk about “fighting” the disease, and anything less, like palliative care, can feel like “giving up” even though this is far from the truth.
| How many of you have spoken with doctors about your wishes about end-of-life decisions? |
There was an article in the New York Times this past weekend about a palliative care doctor’s diagnosis of metastatic breast cancer and her own refusal to accept hospice and palliative care and instead, die on her own terms, trying every treatment possible until her death. It’s very likely that each person who reads this article will have their own interpretation and opinion about this approach. That’s because each of us makes our own choices (hopefully) as to how we will live and how we will die. But the article was thought-provoking in a way that raises more questions than answers.
We have cutting-edge technology and medications, many of which compromise quality of life with no promises in return. Sometimes they extend physical life by mere weeks or months, again without any guarantee of quality of life. It begs the question: Where do we draw the line at quality versus quantity? How do we define quality? Many people say they want quality of life over quantity; hospice is widely available, but the majority of people do not enter hospice until a handful of days before they die. People are unaware that hospice status can change; entering hospice is not an immediate death sentence. Needless to say, this kind of care is greatly underutilized.
Seeing members of my family become gravely ill with end-stage disease or serious illness has brought to mind many of these topics. Hearing about friends my age who are facing a grim prognosis and who are making videos for their kid brothers to remember them by brings the reality home.
For all my self-advocacy and medical knowledge, I do not have an advanced directive. I have voiced my wishes to family members, but legally, that has no weight. How many of you have spoken with doctors about your wishes about end-of-life decisions? How many times has a doctor brought up the subject? Does your family know your feelings and desires should that time come? We don’t think about this when we’re healthy. We don’t like being “morbid” or “depressing.” But as anyone who’s been touched by cancer knows, that can all change in a second.
Have a thought to share with our bloggers?
Leave a comment below!
Leave a Comment