Putting off difficult discussions

The New York Times had an article earlier this week about the difficulty physicians have with discussing end-of-life care treatment with terminal patients. The conversations are difficult, but important, and include such decisions as aggressiveness of treatment, resuscitation and hospice. Guidelines dictate that such discussions take place when the patient has a year left to live, so the patient can make decisions along with their families. But many physicians fail to have those conversations until much later. It is easier to suggest more treatment than to have a difficult conversation with a patient about his or her impending death. But failure to have those conversations may result in more aggressive treatment than a patient desires and death in a hospital when a patient would have preferred the comforts of home. While the conversations are difficult, physicians who learn to have these conversations help their patients live their last days as they wish.