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Handbook for Mortals : Forgoing Medical Treatment

Introduction

Many people say that they do not not want to be tied to machines at the end of life, but how does one get "just the right amount" of treatment? Many treatments are started because there is still some real chance that the patient will improve. Even if everyone thinks the patient is dying, some treatments may be started in hopes of improving comfort. So artificial life support may become an issue for discussion or decision, even if you have plans not to use such treatments when you are "terminal" or the situation is "hopeless."

Artificial nutrition ("tube feeding"), intravenous (IV) hydration, antibiotics, and breathing machines (ventilation) are usually put in place because there is the expectation, or the hope, that a patient is going to recover from a temporary setback. Deciding to use these treatments in the course of a serious, chronic illness demands careful consideration. Once treatments have begun, it can be hard to decide to stop. You and your family need to know that you can stop treatment whenever you firmly decide to do so. Here's an approach to thinking about the issues.

You need to know what it will accomplish and what burdens it will cause. You often will want to try it out before deciding that it is not "worth it" for you. This holds true for simple treatments like antibiotics or insulin, for routine treatments like tube feeding, and for dramatic treatments like ventilators and chemotherapy. The principles are the same, and the need for a compassionate and knowledgeable doctor is also constant.


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To learn more about the book "Handbook for Mortals" click here.