radiolab_logoThere was an amazing piece on the Radiolab podcast this week (Jan 15, 2013) on perceptions of end-of-life care. This is an issue that we face in the Emergency Department as we see many patients who present in their last minutes. This may be an acute exacerbation of a chronically ill person or an acutely injured patient.

Our instinct and training is to “do something,” so it is hard to sit on the sidelines and do nothing. Sometimes the family or patient can give us an indication of what their wishes are. Sometimes we are faced with the decision of discontinuing a resuscitation which may be pointless.

Listen to the podcast and feel free to comment below. There are no right or wrong answers, just a discussion. Let me know what you feel about it.

Article: End of Life Issues in the Acute and Critically Ill Patient
Blog post from doctor mentioned in podcast: How doctors die

Comments (2)

  1. Casey


    An excellent discussion on end of life care.. well worth a listen! I always find it helpful in discussions with patients and families to include the referenced numbers for survival after CPR – 8% alive at 30 days, 3% ‘meaningful’ function. As they point out patients and families often have unrealistic expectations for CPR success.

  2. Kevin K.


    This is a great beginning discussion on the concept of “what is a good death?”. There are a lot of powerful emotions attached to this question as most of us have lost someone close to us, and we can recall both good and bad circumstances that we personally may/may not want for ourselves. In this segment, the specific questions asked to physicians shed light on interventions near end of life, and I find it interesting as a senior medical student that my lack of experience in many areas created vastly different responses than those in the study.

    One of my favorite authors, Daniel Quinn, posed the statement that there is no one correct way to live. Can’t we say the same thing about death? While I do strongly support the idea of informed consent, I have seen many times the persuasion we as physicians can have over patient’s decisions and it is important to recognize what we may consider to be a “good” death may in fact not be the choice of our patients. By answering these questions about ourselves we can gain a strong insight into our own perceptions, and help recognize what may be best for our patients. These questions are inherently ambiguous, but I think the more we can openly discuss end of life care the better prepared we, the patients, and their families can be when it comes to difficult decisions.

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