Letters to the Editor
The New York Times
letters@newyorktimes.com
Dear Editor:
Yesterday, you reported that many older people undergo surgery late in their lives (nearly one-tenth within a week of passing!) and that this is largely due to doctors refusing to discuss the quality vs. length of life with their dying patients. With health care expenditure skyrocketing, these surgeries aren’t an efficient use of resources. Though every life is valuable, it is frustrating that so much is spent prolonging the inevitable and that patients’ freedoms are violated by physicians’ cowardice.
A public health student at UC Berkeley, I propose that doctors be mandated to disclose their patients’ health status to patients and these families. These individuals also need a support system and resources, as the article suggests, to help them understand their decisions’ implications. The amount spent on these surgeries, which seek to prolong life rather than cure disease, could significantly decrease if patients and their families were better informed.
Sincerely,
Elizabeth Hui
2220 Dwight Way
Berkeley, CA 94704
(714) 336-0169
http://www.nytimes.com/2011/10/06/health/research/06medicare.html?_r=1&ref=policy
I found this very interesting! It does seem that there needs to be more regulation in the information given to not only patients, but their families, concerning a patient's health status so that more informed decisions can be made about possible health services. My only concern while reading this is whether there will eventually be a specific time that the physician must refuse to deliver services, such as surgery, due to a patient's health status. In other words, to reduce inefficient use of services, is it necessary that the government controls at which point no more delivery services can be given to a patient because of his or her upcoming mortality? And will this make families weary of physician's falsifying a patient's health status in order to reduce the number of services given?
ReplyDeleteI agree with your argument about how doctors should disclose information to the patients and families. I think that this is a very pertinent issue especially because doctors may tend to suggest surgery so that they can receive more payment even if the patient is very near the end of their life. There needs to be regulations on doctors disclosing ALL information and even suggesting that the patient's life follow its course without the intervention of surgery which may have limited effects. I don't believe this would be overstepping government bounds (to say that they should be regulating what doctors should tell their patients' families) because it would be reducing the inefficiency of resources so often exploited by the greed of doctors in our country. If the government required that families are fully informed, this would decrease costs and limit doctors exploitation.
ReplyDeleteI agree that doctors should disclose the details of a patient's health to the patient and his/her family, and that they should be mandated to give unbiased suggestions for end-of-life care. However, I am not sure that doctors can give unbiased suggestions if they stand to financially benefits from more surgeries. Also, mandates and guidelines for cutoffs for invasive procedures may overstep patient rights. Ultimately, I believe that a third-party, such as a social worker or other knowledgeable medical professional not associated with the hospital should advise patients on their family on hospice/end-of-life options.
ReplyDeleteKaterina U
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ReplyDeleteThis is a very interesting topic, and I agree with your argument that doctors should be more transparent with patients and families about procedures and length of life. However I think there is a lot of uncertainty in terms of when the authorities can step in and stop procedures for the patient. The surgeries are not efficient in terms of saving money, but it can still prolong the life of the patient, which is invaluable to the patient and his/her family. I think it's easy to think that stopping surgery for a person that is going to die will save a lot of money, but to the family, extending the patient's life is the ultimate goal. Perhaps there will never be a law or standard that determines the denial of a patient's life-prolonging procedure, but doctors should communicate with family members better.
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