As medicine gets more and more complex we will need some discussion to help guide physicians and inform the public about thoughtful ways to inlude or exclude medical advances.
Monday Evening News Roundup
My good friend, Blake Butler, announced that he is leaving 880 The Revolution at the end of this year. Blake has been behind the mic for four years. He has been a great progressive voice for Asheville. He will be missed.
Over the last several days, there have been many blog posts and news articles (here, here, here and here) regarding the death of a woman in Ireland. Savita Halappanavar was a 31-year-old dentist who presented to the hospital with abdominal pain. The patient was pregnant. Reportedly, the doctor said that her baby would not live. Now, exactly what happened next is unclear. All that I know is that for some reason the baby was not removed from the uterus. Dr. Savita Halappanavar got sicker and sicker. The exact reason for this is also unclear. Unfortunately, the baby died and shortly thereafter the mother died from sepsis. Some have pointed to the restrictive abortion laws in Ireland as the reason for the mother’s death. In the year 2012, there is no reason to sit around and wait for the inevitable. If the fetus was dead or dying, it is imperative for the physician to save the mother’s life. Now, before I slam the physicians for being a totally unethical, spineless subhumans, I must say we do not have all the facts. I simply hope and pray that this woman was not allowed to die because doctors were afraid to do the right thing. (As a Christian, I feel very comfortable in saying that the right thing to do when there is nothing that you can do for the fetus is to save the mother.)
Continuing on my medical theme, the New York Times had an editorial titled, “Care at the End of Life.” I think the editorial was good. I think it is something that everyone should read. Unfortunately, as a country, we Americans don’t like to talk about death. We hate it. We avoid the subject. It is almost as if by ignoring death we can somehow put off the inevitable. It was not so long ago when we were all familiar with death. 70 or 80 years ago, people didn’t go to hospitals; physicians came to your house. Often, there was nothing the physician could do. The family member would die at home. Now, many of us are shielded from death. Family members die in hospitals. In my opinion, it is actually important that we in the medical profession figure out what it is that patients truly want at the end of life. The only way for us to truly know is for us to open up a dialogue with our patients. As a trauma surgeon, by the time I’m discussing end-of-life issues, things have gone terribly wrong. The patient has been in a terrible car crash and there is nothing more that we can do. In general, it is up to primary care physicians to sit down and chat with their patients. This simple task mistakenly sounds easy, but it is not. Some patients will become offended when approached about end-of-life issues. Some of them believe that their physician has “given up” on them. Some patients will simply go to another physician because they are so upset. We, as a country, have to fix this. Doctors need to become more skilled at discussing end-of-life issues. Patients need to understand that they are in charge of their own medical care. Therefore, the only way that they were in charge is to have this discussion. (more…)