We all need to discuss this

Re: COVID-19 treatments

No good decisions are made at 2 in the morning. Whether it’s making a spontaneous online shopping purchase or ordering a pizza, we are strongly of the opinion that our decision-making is not at its best in the middle of the night.

Unfortunately, illness does not follow a 9-5 schedule. Overnight, people with chest pain or shortness of breath are brought to busy and overwhelming emergency departments. In some shape or form, the question is inevitably asked, “If your heart stops or you are having extreme difficulty breathing, what would you like us to do to save your life?”

These questions are often dreaded by resident doctors, who are usually the ones asking them. No matter how much we try to normalize these discussions, the question almost always invokes a reaction of fear and confusion from patients who haven’t given it thought.

Imagine yourself or you family member being asked this question, sick and alone in hospital, in the middle of the night. Consider the weight of the decision to be made, with little time to think about it, and no input from loved ones.

The COVID-19 pandemic has highlighted that severe illness can affect anyone. We encourage readers to think about what kind of care they would like if they were to become very ill, during this time and beyond. Would you want CPR, intubation, and other life-saving measures if your heart were to stop or you were having trouble breathing?

Talk to your family or friends, as they may be the ones making decisions for you if you are unable. If you are unsure where to begin, there are resources online (for example, on the websites for Speak Up Canada and the Ontario Palliative Care Network). You can also speak to your family doctor. There is no right or wrong answer and our goal is not to sway the reader one way or another. Health-care workers will treat you with kindness and compassion no matter what your choice is. You don’t need to think about it today. You don’t need to think about it tomorrow. But you don’t want to think about it at 2 in the morning when you’re struggling to breathe.

Dr. Anand Sinha and Dr. Manpreet Lamba, Family Medicine Residents, University of Toronto