Friday, April 22, 2011

playing God......with a twist.

i posted earlier about how doctors are sometimes accused of playing God (read here).  here's one with a twist......


72-year-old Mr O was admitted a few days ago with chronic obstructive airway disease & acute renal failure. after he had gone for a CT scan & then connected to a ventilator to assist breathing in the ICU, his daughter then dropped a bomb - she wanted to take her father home.

WHAT?? we were stumped!

if a patient is incapacitated, we often respect the wishes of the family as to how they want treatment to proceed, within reason, of course. so while Mr O will benefit from a few rounds of haemodialysis & a few days on ventilator to tide him over this difficult period, there is still no certainty that he will be back to normal after that. he could remain in critical condition, or even get worse. perhaps it's the lack of a guaranteed outcome that the family chose to defer further treatment. both my colleague & i don't know for sure why the family took this course of action.

however, having to make many difficult decisions each day, it does lighten our burden just a bit when the patient or the family make their own decision & boldly adhere to it.

it's out of our hands now.

24 comments:

house-tai said...

maybe the family can't afford the hospital bill?

doc said...

House-tai,

we considered that possibility but we didn't confirm. however, if that were the case, the family would have requested transfer to a public hospital. here, they were adamant they want to bring Mr O home.

Adino said...

Very strange, but my guess is financial reasons. Or maybe they were influenced to make the decision by alternative medical practitioners.

Yvonne Foong said...

COPD, you mean?

Well, whether the family can afford the bill or not, I think the hardest part is in making decision on whether to prolong your father's life or let him go. It's scary when the decision is all in your hands. If you make the wrong decision, you will cause your father to suffer. I couldn't bear the thought of causing my father more sufferings and decided to let him go. Even then, the decision to let him go was very difficult. I felt so powerful and so scared of my power to determine my dad's death.

I am sure it was not an easy decision for this lady to make.

missyc said...

the patient MrO could have told his family his wish not to prolong his suffering if it comes to that stage.

its tough to make that kind of decision, been in that situation when the doctor (oncologist) told me & hubby* to bring late sil home after all the stress of bringing her to the hospital hours earlier. her hubby was at the church for their eldest daughter's rushed wedding & we* both were not in the right frame of mind.

I wonder if living will is recognised here so caregivers/ care providers do not have to play God

house-tai said...

or maybe they just can't wait for Mr O's will to be unveiled....but let's hope not!!

reanaclaire said...

Yeah, maybe main reason is hospital bill too.. after weighing the consequences.. the other day, my MIL stayed in hospital for nearly a month, no operation whatsoever, it cost around 28K... eventually she passed on in the hospital..

doc said...

Adino,

Mr O would not survive without the ventilator, so it's highly unlikely alternative medicine will work.

doc said...

Yvonne,

COPD is the american term for COAD.

yes, it's a difficult decision. looking back, perhaps the family should be lauded for making it.

doc said...

MissyC,

that is possible, but apparently a living will is not recognised here.

http://www.facebook.com/pages/Will-Writing-Malaysia/9016894020

doc said...

House-tai,

that's a terrible motive to defer crucial treatment.

doc said...

Claire,

if Mr O had stayed on in ICU, that may have been his hospital bill, too!!

Andrea Wh@tever said...

Hi Doc,
I would imagine that it was not an easy decision for the family either; especially if financial concerns played a big part, coz no matter what, we always want the best for our loved ones.

Happy Easter and May the healing love of The Risen Lord continue to flow into your hands.

wenn said...

families have their own say..

doc said...

Andrea,

it's true - it's a painful decision, so difficult that perhaps it's a fate that only God should determine.

blessed easter & may God's grace be upon you & your family。

doc said...

Wenn,

& we try to acconmodate as much as possible.

Shirley Buxton said...

Ah, life. Full of difficult--almost impossible--decisions. Interesting scenario.

I've read around your blog a bit this morning, and have quite enjoyed it. Glad to have found your place. Will be back.

Blessings....

shirley

doc said...

hi Shirley,

thanks for dropping by & for your comments.

Ann said...

Hi Doc,

Thanks for visiting.

I have read to your back post. I suppose you are a real doc.

You came to the right person to discuss this issue.

The man in this post is rather young to withdraw treatment. What ever reason they have.

Back 21 years ago, I was told my son was dying because he was so badly involved. So they suggested we let nature take it's course. Hard decision.

I just published my book on my journey.

Your boleh from Malaysia? I am from Sarawak.

doc said...

hi Ann,

thanks for your comments.

let me know how i can purchase an autographed copy of your book.

i was born & bred in JB.

Yvonne Foong said...

When i told dad's doctor that I wanted to sign a DNR and told him not to resuscitate him if he fails again, he doctor became solemn. He seemed enthusiastic abt dad's recovery, saying that he was better but not sure how much longer will he stay that way. So when I told him of my decision, his enthusiastic expression turned solemn, which could have been misinterpreted as displeasure too if not careful. I often wondered what his true thoughts were.

doc said...

Yvonne,

now, you'll never know.

Michelle Mak said...

probably they are just thinking wats the best for their dad..rather than he suffer and at the end of the day..we don even know wat is the outcome of the whole process...

2nd probably the bill is another matter.. hahaha as we know larr private ma... everything also double one... :P but no doubt with full of attention if compared to government hosp

to me.. and to my point of view is the quality of life tat he goes thru is the most important thing tat i can think of :)

doc said...

Mich,

only the family knows why they chose that course of action.