Knockin’ on Heaven’s Door: End of Life Decisions and Discussions

Authors

  • Curt Tribble, MD Division of Thoracic and Cardiovascular Surgery, University of Virginia Health System, Charlottesville, Virginia, USA

DOI:

https://doi.org/10.1532/hsf.1849

Abstract

More than 2.5 million people die in the United States each year. For the majority who live out their final days in various institutions or in hospice care, decisions must be made about which treatments to administer, which treatments to stop, which treatments to continue, and which treatments to back off of. Thus, while death remains inevitable, its timing is often very much a function of human agency. Once it was common to speak of “nature taking its course,” but now it has become as common to view death as something about which people have some control [Meisel 2008].

References

DeMarco P. 2016. A letter to the doctors and nurses who cared for my wife. mobile.nytimes.com/2016/10/06/well/live/a-letter-to-the-doctors-and-nurses-who-cared-for-my-wife.html.

DeMartino ES et al. 2017. Who decides when a patient can’t? Statutes on alternate decision makers. N Engl J Med 3761478-82.

Gawande A. 2014. Being mortal: medicine and what matters in the end. http://atulgawande.com/book/being-mortal.

Gubar S. 2017. At the end of life, a way to go gentle. The New York Times. https://nyti.ms/2oqtFEm.

Jones JW, McCullough LB. 2001. Patient-originated futility insight: ethical right or ethical plight? J Vasc Surg 54:237-9.

Meador CK. 1999. A Little book of doctors’ rules, First edition. ISBN-13:978-1560530619; ISBN-10:1560530618. www.cliftonkmeador.com

Meisel A. 2008. End of life care. www.thehastingscenter.org/briefingbook/end-of-life-care.

Mendelsohn BA. 2013. What is natural? JAMA 309:1783-4.

Olsen ML. 2010. Ethical decision making with end-of-life care: palliative sedation and withholding or withdrawing life-sustaining treatments. Mayo Clin Proc 85:949-54.

POLST: Physician orders for life-sustaining treatment. The Coalition for Compassionate Care of California. http://capolst.org.

Simmons JD. 2012. Speaking from the heart: end-of-life discussions in the ICU from a surgeon’s perspective. J Surg Ed 69:441-2.

Tribble C. 2016. A practical minded obsession. Heart Surg Forum 19:1-4.

Tribble C. 2016. On becoming a doctor of humane letters. Heart Surg Forum 19:150-2.

Tribble C. 2017. Grandmother rules: crucial conversations with patients and families. Heart Surg Forum 20:2-6.

van Dyke H. Gone from my sight. allpoetry.com/Gone-From-My-Sight.

Zier LS et al. 2008. Doubt and belief in physicians’ ability to prognosticate during critical illness: the perspective of surrogate decision makers. Crit Care Med 36:2341-7

Published

2017-06-29

How to Cite

Tribble, MD, C. (2017). Knockin’ on Heaven’s Door: End of Life Decisions and Discussions. The Heart Surgery Forum, 20(3), E111-E115. https://doi.org/10.1532/hsf.1849

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Section

Article