The Death & Dying Rollercoaster
Death is different from any other medical conversation.
When a doctor announces to a patient nothing more can be done, the discussion moves into palliative care. The main goal is easing the pain and increasing quality of life.
To many patients, this discussion marks the moment when their care team has given up on treatment. But there is a significant problem with this approach.
It is very late into the process and can result in stubborn treatment that harms more than helps towards end of life.
The main difficulty, however, remains this: It is very difficult to accurately estimate the life expectancy of a patient. Whether one opts for a discussion early or late, a doctor's prognostic remains but a guess. For patients, the rollercoaster of hope and despair, goodbyes and extended life, is difficult to link together.
If the field of healthcare was definitive with life expectancy, discussions on treatment options might be a matter of courage. As it stands, the timing of these conversations is a complex question.