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Caring for Patients at the End of Life

It's truly incredible what modern medicine can do: certain cancers can be cured or brought into remission, patients can receive devices to help their hearts beat, and organs can be transplanted to replace those that no longer function. Still, we all have to face the reality that we will eventually die.

It can be difficult to talk about death and dying, even for many physicians. Often with our patients, we're focused on treatments and cures, and acknowledging the possibility of death can seem like a failure.

Most of our patients--indeed, most of us as individuals--want to live a good life, and as doctors, we try to help them achieve that. Sometimes, though, no matter what we do, the disease gains the upper hand. If we can't cure our patients, we can still act as agents of hope. And for those who are terminally ill, the hope that we can offer them is achieving a good death.

Just as people have different conceptions of what constitutes a good life, so do our beliefs surrounding a good death vary. But for many, quality of life at the end of life is key. That may mean forgoing chemotherapy that is unlikely to have any survival benefit, expressing end-of-life care preferences through advance directives, and planning where and how one would like to die. Frank and compassionate conversations between doctors and patients are critical so that individuals near the end of life have the time to make these decisions carefully.

At Weill Cornell, our new Center for Research on End-of-Life Care, headed by Dr. Holly Prigerson, aims to improve the care and support we provide patients nearing the end of life. It's hard enough when we lose someone we love. Sometimes knowing that they left peacefully can make it just a little bit easier.

Posted October 22, 2014 10:05 AM | Permalink to this post

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