The power of words

Re: “End-of-life talk betters patients’ remaining time,” July 18.

Undoubtedly, it helps very ill patients to discuss with their physicians about what might transpire in the near future. However, the article’s fairly explicit tone suggests patients really need to consider how grim it might be to subject oneself to the range of possible interventions that might sustain life for some period, but possibly without great quality.

When my late partner, Jim Gripton, was hospitalized with an infection related to his multiple myeloma, a hospital physician, unbeknownst to the family, had an “end-of-life” discussion with Jim. Jim seemed suddenly to lose his enthusiasm for living and was subdued, if not resigned. The discussion had left him without the hope he previously had, if not about recovery, but about his capacity to keep on living. He would likely have died at some point in the near future, but he did not need to feel that he had no options and possibly, that the hospital physician envisioned no alternatives but death fairly soon.

I suggest physicians undergo considerable clarification regarding their own values and attitudes about life-and-death decisions and that they consult with family members before discussion of what might transpire. Or they might refer the patient and family to a hospital social worker who would review the patient’s situation and their perspectives. Social workers are more likely to have examined their own views on life and death and be less ready to prejudge the direction a patient may wish to take.

Finally, drop the name “end-of-life” talk which immediately suggests “your time is up.” One could simply be engaging in a periodic review of medical and other options with this patient and family.

Mary Valentich, Calgary