Deciding when to stop treatment

Aug 3, 2014

It is one thing to have a natural death, but it is a different issue entirely when a potentially fatal illness forces you to make difficult treatment decisions.  These decisions can often be complicated by the wishes of the patient, family members, doctors, and even spiritual beliefs, but there are ways to make the process less difficult those involved.

This week on “Take Care,” Dr. Barron Lerner discusses how best to deal with situations in which medical treatment becomes futile.  Lerner is a professor of medicine at New York University and the author of The Good Doctor:  A Father, a Son and the Evolution of Medical Ethics.

Click 'Read More' to hear our interview with Dr. Lerner.

The unfortunate reality of modern medicine is that treatments do not always work.  Doctors and patients can do their best to fight a disease, but they are not always successful.  Lerner is all-too familiar with such a situation.

“At some point, we tend to run out of options.”

In order to properly navigate medically futile cases, candid and direct conversations need to occur between the doctor, the patient, and family members.  Lerner says that it helps to have discussed possible treatment plans prior to the patient taking a turn for the worse.  Medical directives are often used as well.

“[T]here have to be difficult decisions made and the information may not be there,” says Lerner.

Giving patients frequent reality checks helps keep both the patient and family aware of their situation and provides them with the knowledge needed to make better-informed decisions.

Even if a doctor does his or her best to keep the patient informed about treatment options and provides them with realistic prognoses, deciding when to stop treatment can be a very complex matter.  Family members’ wishes may conflict with those of the patient and spiritual beliefs can also contribute to the decision.

“Religion throws a curveball,” Lerner says.

Many people who are religious believe that their religion dictates that they do everything possible to stay alive.  For those people, there are spiritual guidance counselors available at most hospitals.

Even though it is never easy to make the right medical decisions for a severely ill patient, Lerner says that open discussions that involve the patient is the most effective way to deal with these situations.

“It’s rarely an error to broach these subjects with pretty much anyone.”