The short answer would be that we have seen countless fruitless outcomes. As an example, the John Hopkins Precursors Study collated end-of-life decisions of 800 physicians graduating from Johns Hopkins between 1948 and 1964. Indeed this study was done a long time ago, but I feel it’s still pertinent today. Compared with 20% of the general public, 64% of physicians had an advanced directive (which tells us which life-saving procedures you’d like). Additionally, nearly 90% of the physicians did not want CPR if they were in a chronic coma. Only 25% of the general public stated they did not want CPR if they were in a chronic coma.
Physicians know that CPR rarely works. A 2010 study of 95,000 cases of CPR in Japan demonstrated that only 8% of patients who’d received CPR survived for more than one month. Only 3% of those lead “normal” lives.
Futile treatments are commonly performed. Often patients do not fully understand the risks and benefits of their therapy. One of my jobs is to delineate the risks and benefits. The patient can decide what they’d like done.
I believe we have an obligation to our patients to share with them the reality of the care they received. I check in with my patients to understand what is important to them.
- Do they want every medical option available?
- Is there an event they want to live long enough to attend?
- Do they value comfort and quality of life above all else?
Questions to ponder. And, let your family and doctor know your answers.