End-of-life Care & Advance Directives Stymies Surgeons

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Advance Directive

Photo Courtesy: mountnittany.org

When we have a complication, condition, disease or a surgical emergency, we head to hospitals where doctors and surgeons will tend to us. Apparently, there’s something called as an advanced directive, which outlines what, can and cannot be done if the patients are unable to decide about the surgery by themselves.

Also called as the end-of-life care, advanced directives or as living wills, many surgeons feel that these directives tie their hands behind their back and do not allow them to exercise all their experience and tools to succeed with the surgery, according to a recent survey published in the Annals of Surgery.

When Margaret Schwarze — an assistant professor at the University of EWisconsin School of Medicine and Public health – asked 912 surgeons who work on complicated and risky operations all the time about these advance directives, more that 4 out of 5 surgeons do ask about the life support patients would like to limit. However, just 50% of the surgeons actually ask about the advance directives which could include what sorts of life support systems should be used, whether the ventilator should be used, etc.

Most surgeons feel that these directives complicate surgeries, which are already complicated. In fact, they feel that the advance directives are completely irrelevant. Further, more than 50% of the surgeons refuse to operate if an advance directive limits or keeps restrictions on whatever can be done to keep the patients alive.

While the number of patients using advance directives has gone up steadily over the years, surgeons feel that this sort of thing introduces tensions in between the patient and the surgeon. The U.S laws also help putting too many bottlenecks for patients to put these advance directories in place.

Living will or an advance directive is a tactful way to talk to your loved ones about their wishes, their feelings, and about what they want. It also helps guide doctors and surgeons. Medical decisions can be tough. As such, these directives help give a path and open a sustained communication between all parties involved.  Without the directive, and in the case of the patient unable to talk or is in no position to talk, it’ll be impossible to come to a decision especially when the doctors don’t intervene.



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