What should a doctor recommend for a 90 year old man with pancreatic cancer and liver metastases? Palliative care? Hospice? Those would seem to be the most reasonable options. If I were that 90 year old man, that’s what I’d recommend. Unfortunately, I know from experience that that is all too often not what happens. I know and have seen the ordering of many invasive tests that won’t change the outcome.
So does Buckeye Surgeon.
American medicine, as it is practiced now, all too often takes on a momentum that is very difficult to stop, a momentum demanding more, more, more, more, even in the face of a hopeless situation. Sometimes it’s driven by the family’s desire that doctors do “everything possible,” but, as this case demonstrates, it can happen even without such an insistence. It seems to happen even though individual physicians involved know there’s no hope and that what they’re doing is futile. It is a major contributor to the way that end-of-life care makes up such a large portion of what we spend on healthcare.