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Thoughts on Frontline's Facing Death
Posted by Melissa Barber on December 2, 2010
I came away from PBS's Frontline episode from November 23rd, "Facing Death", with mixed feelings. Like most people I found discussing the episode online, I was impressed by the generosity of the doctors, patients and families for allowing Frontline to keep their cameras trained on them during these excruciating and highly personal moments. Programs such as these need to stay in the limelight and continue to call attention to the necessity for all of us to have discussions with our loved ones to ensure our end-of-life care is what we want.
But what I found frustrating when I watched the program was the treatment of death as an enemy to be conquered—even at the cost of a denigrated quality of life. The often repeated refrains throughout the episode were 'there was always something to do' or 'we can't stop treatment'. Though the words "hospice" or "palliative" were rarely mentioned throughout the program, I got the feeling that enrolling in hospice or palliative care would have been considered "doing nothing" or "giving up".
I concede the focus of this episode was not on hospice or palliative care, but perhaps the absence of concurrent palliative care when treating people with terminal or life-threatening illnesses is part of the problem. As noted in a recent study published in The New England Journal of Medicine, terminally ill patients assigned to receive early palliative care had a better quality of life, fewer depressive symptoms, received less-aggressive end-of-life care, and (here's the kicker) lived longer. Another study in the Journal of Clinical Oncology found patients had a much better quality of life when they died at home with hospice and their families were less likely to be at risk for post-traumatic stress disorder if their loved one didn't die in the ICU.
Perhaps a broader medical team is needed when a person is faced with a terminal illness. In addition to the aggressive-treatment bone marrow transplant team, the health care professionals could also include doctors who specialize in palliative care and have more training on how to talk to a person about death and dying. With a more diverse group of medical professionals the patients and their families could hear and better understand all the options and possible outcomes.
In the words of Judith Nelson, a palliative and critical care doctor interviewed in the show:
Nobody wants to die. And at the same time nobody wants to die badly. And that is my job. My job is to try to prevent people from dying if there is a possible way to do it that will preserve a quality of life that's acceptable to them. But if they can't go on, to try to make the death a good death.
If they're given all of the data points from a diverse group of specialists, patients would be better able to make more informed decisions while they're still able to express their desires. More detaled information—such as the success rates of certain procedures, what life will be like if the patient doesn't beat the odds after they go through the procedure, and what other care options are available that work along side curative treatments or therapies that shift toward comfort care—would empower patients to make the best decisions for themselves. By getting a more complete picture of all the options, the majority of Americans would hopefully achieve what we all wish for at end-of-life: a peaceful death at home surrounded by their loved ones celebrating a life well lived.
Did you watch "Facing Death"? It's not too late; the full episode is available online. I'd love to hear your thoughts after watching the program.
Posted on December 2, 2010 in The Arts
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