WASHINGTON (AP) — Dr. Angelo Volandes remembers performing rib-cracking CPR on a frail elderly man dying of lung cancer, a vivid example of an end-of-life dilemma: Because his patient never said if he wanted aggressive care as his body shut down, the hospital had to try. He died days later.
Years later, the Harvard Medical School researcher now tries to spur conversations about what care patients want during life's final chapter through videos that illustrate different options.
"This is about patient empowerment," said Volandes, who describes his program in a new book aptly titled "The Conversation."
Most Americans say they'd prefer to die at home, with treatment to free them from pain, but the prestigious Institute of Medicine says the reality too often is unwanted care and not enough comfort. One main reason: Doctors have a hard time discussing dying and patients don't know what to ask. Now the institute is recommending changes in the health system to help patients — not doctors or circumstances — dictate their care, and it all starts with some straight talk.
"These conversations should be part of a life cycle, not just at the end of life," said Dr. Philip Pizzo of Stanford University, who co-chaired the institute's panel that is holding meetings on how to implement the recommendations. "Regardless of whether an individual is choosing more or less, both ends of that spectrum are important and we should honor preferences."
