GAWANDE LETTING GO PDF

July 27, Thank you for the post, Alex. First of all, he was willing to be there. But most of all, he had the concern, the ability, and the courage to help the family face the fact that no amount of tertiary care was going to stop the cancer. July 27, at PM. Wendy S.

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Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars.

In ordinary medicine, the goal is to extend life. Hospice deploys nurses, doctors, and social workers to help people with a fatal illness have the fullest possible lives right now. That means focussing on objectives like freedom from pain and discomfort, or maintaining mental awareness for as long as possible, or getting out with family once in a while. Step by step, Sara ended up on a fourth round of chemotherapy, one with a minuscule likelihood of altering the course of her disease and a great likelihood of causing debilitating side effects.

An opportunity to prepare for the inevitable was forgone. And it all happened because of an assuredly normal circumstance: a patient and family unready to confront the reality of her disease. For most situations, however, I prefer the more martial view that death is the ultimate enemy—and I find nothing reproachable in those who rage mightily against the dying of the light. The fact that we may be shortening or worsening the time we have left hardly seems to register.

We imagine that we can wait until the doctors tell us that there is nothing more they can do. But rarely is there nothing more that doctors can do. Two-thirds of the terminal-cancer patients in the Coping with Cancer study reported having had no discussion with their doctors about their goals for end-of-life care, despite being, on average, just four months from death.

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Letting Go

Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. In ordinary medicine, the goal is to extend life. Hospice deploys nurses, doctors, and social workers to help people with a fatal illness have the fullest possible lives right now.

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“Letting Go” – The New Yorker’s Atul Gawande, on giving up life to live

Medical innovations have enabled us to wring a few more days, or months, out of life for the terminally ill; and anyone who's lost a loved one knows the outsize value of an extra hour. But as Atul Gawande , MD, works out in a heart-breaking New Yorker piece , aggressive end-of-life intervention often comes at great cost: We spend thousands of dollars on chemotherapy, surgery and intensive care stays, often depriving patients of the chance to be with family, enjoy physical touch and stay mentally aware as they approach death:. The hard question we face, then, is not how we can afford this system's expense. It is how we can build a health-care system that will actually help dying patients achieve what's most important to them at the end of their lives.

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Atul Gawande: “Letting Go: What Should Medicine Do When It Can’t Save Your Life?”

A surgeon and writer, Dr. In his article Dr. Gawande explains that expense is the reason that end-of-life medical care has become a topic of discussion. However, if the disease worsens, treatment escalates, and cancer-related expenses create a U-shaped curve. The discussion of end-of-life care should go far beyond money.

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