Honoring people’s end of life wishes is sometimes hard for me but not as hard as when they do not specify their wishes. Without a clear end of life directive, loved ones can die in excruciating pain without pain medications. It is distressing when patients die in the hospital undergoing aggressive measures scared and alone. I am saddened when I witness people using their limited time to chase futile cures in lieu of spending time with their loved ones.

I am an optimist but I am also a pragmatist. I think it is important to be assertive and exhaust all means in seeking treatments but there comes a point where the efforts and costs outweigh the valuable return of precious conscious time with those we love.

The consistent phrase I hear from my patients on their death bed is “I wish I spent more time with…….” I have never heard someone say, “I wish I spent more time at work”, “I wish I got that PhD” or “I wish I was still in the hospital for another surgery or treatment.”

This month’s posts speak to these difficult choices we face at End of Life:

– A nurse of 30 years in a contributing story reflects on a dying person’s final wishes

-A video clip from a PBS production discussing End of Life conversations and the Health
Care Reform Act with Dr. Atul Gawande, surgeon, author and medical writer for
The New Yorker.

-News update on the Quality of Global End of Life Index for 2010 recently posted in
the Economist Periodical. You will be surprised where the U.S. ranks.