QUESTION: What are we trying to achieve by treatment?
That is THE question everyone involved in medical decision making needs to ask. Who is everyone? Physician, patient, and family.
Most people (patients and family) faced with an illness look for the treatment to cure them, to return them to our life as it was before the illness occurred. However, with today’s medical accomplishments, fixing or curing may not be the only goal. Keeping the person alive, even if quality of life is sacrificed greatly, may be the medical goal. How do we know what the goal is? We need to ask. Yet most of us don’t. We just assume our physician is thinking the same way we are.
What questions do we need to ask and consider to ensure that all involved are working in harmony toward the same goal?
“Can my illness be cured?” If you have a broken leg you can be pretty sure your goal and your physician’s are the same--to get you walking again. If you have cancer, you might be expecting the physician to make it go away and return you to your normal life. Your physician may be expecting to slow your tumor growth or shrink it’s size a bit. But not cure you. See the difference?
“Can my illness be put into remission if a cure isn’t possible? What are the chances the proposed treatment can put the disease process into remission? What about inhibiting further progression? What about tumor shrinkage? These are all pertinent questions we need to ask when we are looking at any particular treatment options.
“Just how sick am I going to be with the treatment? What are all of the side effects?” The gains of a particular treatment may not be worth the debilitation caused by its medications and side effects. Sometimes, we’ve added two weeks to a pain filled life at the cost of three months of agonizing , incapacitating side effects.
Remember, we are more than a physical body, we are emotional, mental, and spiritual. What are we doing for those parts of us when we pursue treatments without really understanding what we are getting ourselves into or what the expected outcome is? Are we headed for comfort or discomfort? Will the rest of our days be filled with illness and possibly pain?
Will the discomfort be worth the final outcome? Absolutely, if a cure is expected. Probably, if remission or even inhibiting progression is expected. But if with the proposed treatment we will have a difficult time with maintaining the disease status quo, let alone fixing it, then is it worth it?
There is no right or wrong answer to all these questions. Some people will want to do every possible thing to live just a few more days, no matter the condition of the physical body. Others will want to take the time and live the best they can without medical intervention (except for pain management).
If the patient can’t ask the questions (due to dementia or unconsciousness) that in itself can be an answer regarding body functioning and quality of life activities and the pursuit of treatments.
We can’t make choices that are best for us if we don’t have honest, accurate information upon which to base our decisions. We need to ask questions! We need to do our research! The Internet is a wonderful tool. It can help us get unbiased information. It has put a world of knowledge literally at our finger tips. Knowledge is power, knowledge reduces fear, and knowledge helps us make good decisions.
Something more about Good Decisions...
Taking an advocate to appointments, using the internet, getting second opinions... these are ways to help navigate the waters of a life threatening medical condition. A Time to Live is another way to get support if your illness is unfixable. A Time to Live helps make your gift of time a rich, meaningful time. And there is also support at my Facebook Group, End of Life Care and Bereavement.