End of Life Care

When only about one third of Americans leave living wills or specify end of life protocol, physicians and hospitals are left to consider the costs and benefits of end of life care themselves. Some issues that remain include:

Should a feeding tube be installed when the patient can no longer be nourished by mouth? Should a ventilator be attached when breathing independently becomes difficult? If the patient has severe dementia, should antibiotics be used if pneumonia develops? Should cardiopulmonary resuscitation be attempted if the heart stops beating?

Or should the patient receive just comfort care — treatment for pain, nausea, anxiety, depression and other debilitating symptoms — and be allowed to die a natural death?

Lacking guidance from patients and families, physicians who know better too often end up providing costly life support for the terminally ill even though there is no hope for an improved quality of life.

Dr Charles A. Bush, the medical director of Richard M. Ross Heart Hospital at the Ohio State University, believes this adversely impacts the health care system through higher costs and debilitating procedures for patients.