Death by default

Offers some slightly reassuring news for those concerned about being kept alive by gadgetry inappropriately prolonging life. New national survey of doctors and nurses who treat dying patients reveals that they do not endorse 'overly burdensome' care to patients nearing the end; Reported in the 'American Journal of Public Health, volume 83, number 1; Reasons given by doctors and nurses on why they often act against their conscience in providing care to the terminally ill; Details.

By PT Staff, published on July 01, 1993

MEDICAL ETHICS

ONE OF THE MORE PERVASIVE MEDICAL nightmares of our times pits an otherwise-dead patient against gadgetry inappropriately prolonging life.

For those concerned about such a final indignity comes some slightly reassuring news. A new national survey of doctors and nurses who treat dying patients reveals that they, too, do not endorse "overly burdensome" care to patients nearing the end. They support the right of patients to forgo unwanted treatment.

But unfortunately, according to the survey, doctors and nurses often act against their conscience in providing care to the terminally ill, reported the American Journal of Public Health (Vol. 83, No. 1).

Why, then, do they do it? Here are some reasons the survey uncovered:

o Medical personnel are reluctant to withdraw treatment once they start it

o They're not aware of national guidelines on the use of life-sustaining treatment;

o They aren't sure about the law, ethics, or professional standards;

o They are not psychologically comfortable with stopping treatment;

o They're uncomfortable soliciting patients' personal views on what is an acceptable quality of life.

"What we need" in this country, conclude the the authors, "is a better understanding of ethics and the law, and the courage to talk openly about death and dying."