Third of dying patients suffer ‘invasive’ care
Unhelpful or harmful treatment given at end of life as relations expect too much from doctors
MORE than a third of dying elderly patients receive “invasive and potentially harmful” treatments in their last weeks of life, the biggest review of its kind has found.
Analysis of data from 1.2 million patients worldwide found some were being subjected to “excessive” and un- necessary treatments that made no difference to the course of their illness.
Researchers said part of the issue was families who struggled to accept that nothing more could be done for their loved ones, and who expected “heroic” interventions from doctors.
The review, led by the University of New South Wales in Australia, involved 10 countries, including England. It found around a third of elderly patients with advanced, irreversible conditions such as cancer were given treatments that were of no benefit to them.
One third of terminally ill cancer patients were given chemotherapy in the last six weeks of life, while 10 per cent of all patients in irreversible decline were admitted to intensive care units.
A third of such patients were given antibiotics and heart medicines, while almost as many were put through dialysis, blood transfusions or other life support. A quarter of patients who had Do Not Resuscitate orders in their notes were resuscitated, while up to half of such patients underwent invasive blood tests and scans, the study found.
Dr Magnolia Cardona-Morrell, who led the research, said advances in medicine had led to “unrealistic” expectations. She said: “It is not unusual for family members to refuse to accept the fact that their loved one is naturally dying of old age and its associated complications and so they pressure doctors to attempt heroic interventions.”
Doctors were “torn by the ethical dilemma” that they were trained to save lives, instead of focusing on the patient’s right to die with dignity, she said, adding that non-beneficial treatments were those which “prolong suf- fering rather than survival, that can potentially cause harm, and are sometimes given against patients’ wishes”.
Prof Bill Noble, medical director at the terminal illness charity Marie Curie, said: “Television and film is often guilty of depicting medicine as a heroic battle rather than something that’s facilitating a natural lifespan. This damaging portrayal perpetuates the unrealistic expectations about what doctors can do for patients, especially those with terminal illnesses who might be approaching the end of their lives.”
The study was published in the International Journal for Quality in Health Care.
‘It is not unusual for family members to refuse to accept the fact that their loved one is naturally dying of old age’