Good Palliative Care Teams Change The End-of-Life Conversation

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The Wall Street Journal recently held a wide-ranging End-of-Life discussion with a host of industry experts.


One issue they addressed is:

“Why Palliative care doesn’t begin on the day of diagnosis so patients and families can focus on the time they have left together?”

Studies found “earlier use of Palliative care not only extends life; it reduces costs and promotes better overall health in patients.”

Dr. Robert Wachter, associate chairman of the Department of Medicine for the University of California-San Francisco, believes many times patients’ final days turn into a “medical version of torture” because doctors continue to practice aggressive “hero medicine” when the person receiving treatment would have preferred to go with dignity. “Not only is this inhumane, it is wildly expensive for families and the healthcare system,” Dr. Wachter said.

Mounting evidence suggests some of the most expensive and aggressive treatments do not make the patient better; they cause more suffering. Yet “in America, we continue to adhere to a ‘more is better’ philosophy, coupled with a literal ‘never say die’ attitude.”

Having access to a good Palliative care team can change the End-of-Life conversation.

“Their goal is always to ease the suffering of a patient. When physicians ask, ‘Should we do everything or nothing?’ Many people will say, ‘everything, of course,’” said Dr. Wachter. “A good Palliative care team helps ask a different set of questions, including, ‘What are the patient’s goals?’ and ‘How can we do everything to achieve them?’”

Pose the question that way and it’s been proven a large number of patients “choose options other than the ‘full-court press.’” “This approach leads to a more humane end to someone’s days on Earth in a comfortable environment surrounded by loved ones. Sometimes, less really is more.”

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