Monday, April 25, 2005

On "Withdrawing" Treatment/Care

In a blog that I respect a lot, I recently came across an old post discussing "withdrawing treatment." I wanted to use that reminder to comment on linguistics a bit.

I hope we will shift away from using the terminology "withdrawing" care or treatment. When people decide to discontinue aggressive curative measures and to begin focusing on the large tasks of end of life, we are not "withdrawing care." Instead, we are shifting the goals of care. Health care providers continue to provide care even when we are letting natural death occur.

We are not even withdrawing treatment; we are still treating symptoms. Our goal is to keep patients comfortable. Instead of trying to cure disease (often times at the expense of comfort), we are aggressively controlling symptoms such as pain and nausea.

Putting effort into changing this terminology within medical culture as providers will ultimately help families, patients and our colleagues make this shift, too. Some doctors use the statement, "There is nothing more that we can do" when telling patients and families that there are no more curative options for their particular disease. This sends a message of "giving up," anticipated abandonment by their health care providers, and a lack of hope.

Contrary to that common statement, there is always more that we can do. There is always something we can hope for - a peaceful death, being comfortable, dying somewhere we feel safe, making ammends with our loved ones. And as we are helping patients to reach these goals, we are providing care.

1 comment:

Anonymous said...

I agree....that is well said. We are facing these issues right now as my father in law is passing. We are now realizing that removing the machines and letting a natural death occur is much more real care than continuing to prolong this time of death and the suffering that can accompany it. Thanks for your clarification of this term.