Joshua M Hauser MD
This article was published by Medscape Internal Medicine on September 25, 2014
Listening to Patient's Wishes
"When a horse breaks his leg, they put him down; why can't you do that to me?" The patient who asked me this recently is a 76-year-old man dying of gastric cancer who had pain from pressure ulcers he developed as he became increasingly debilitated and had no one to help get him out of bed. He also had haunting memories of caring for his parents as they died in pain decades ago. I explored how he was suffering; I suggested what we could do for his pain and what resources we might be able to gather to help him at home. I listened as he told me about his time with his parents. He was not satisfied.
And I left our interaction wondering what we would do next to help him. Two days later, we had a family meeting with his closest relatives, a niece and a nephew, and I asked how he was feeling about our conversation and wanting us to help him die. "Oh, that was just then. I feel OK now." I asked whether it was the pain medications or the newly developed plans for a nursing facility. "No, just not feeling that way anymore," he told me.