Atul Gawande: Letting Go Essay

The term “hospice” goes back to medieval times where it was referred to as a place of shelter and rest for the ill or weary travelers on a long journey (NHPCO, 2016). In 1948, the term was referenced to by Dame Cicely Saunders, a physician, for dying patients (NHPCO, 2017). Saunders created the first modern hospice program, St. Christopher’s Hospice, located in a suburb of London. However, it wasn’t until a visit to Yale University, in 1963, Saunder’s gave a lecture on the concept of hospice care. During the lecture, she emphasizes the differences before and after symptom control care. Thus, this lecture was the stepping stone for the advancement of hospice care.

Hospice exists in the hope and belief that, through proper care and the encouragement of a caring and sensitive team, patients and their families may be free to achieve some level of mental and spiritual preparation for death that is comfortable to them. The goal is to help

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

It was not intended to make readers sad or necessarily agree with his decision, however, to examine their own life and situation and to contemplate death, as it is inevitable for everyone. Most people are bound to have to face a similar choice as Clendinen. Maybe not in the same extreme measure, but most people will have to make a decision for a family member who is no longer capable of making medical decisions for themselves. Clendinen achieved his purpose and readers should walk away from this article recognizing exactly what Clendinen’s beliefs are on death, and it ought to make them curious about their own thoughts and beliefs. At the very least, talk with their loved one’s before they ever become ill and find out their loved one’s wishes. Most people are skilled on how to live their life, but how many are taught to embrace the

Getting prepared for death can be an exhausting experience for the patient and their family. It is very important that the patient not only knows what they want as far as their right to receive or reject treatment and medications or knowing whether they want to receive palliative care at home or in a hospital setting to include the advantages and disadvantages of each. The main focus of this paper is to give the reader an in depth look on how an end of life crisis affects a patient and their family. Ella is a breast cancer patient who just came out of remission and is at the end of her life.

For many patients with incurable illnesses around the world, the time to stop particular treatments is an ongoing argument. Atul Gawande, a surgeon and staff writer for The New York Times, has been following this debate since his medical practice and strives to inform the public on how to handle mortality. In his article, The Best Possible Day, Gawande employs an anecdote, Ethos, and a eulogy to encourage the audience to consider adjusting a sick person’s care according to how they feel.

The next few themes of this article include the discussion of pain, loss of pleasure in life, and the right time to die. The carers felt responsible to prevent their loved ones from experiencing pain and suffering all of their later years of life. They stated that caring for someone they loved with dementia that was extremely unhappy with their quality of life brought up ideas of assisted suicide. They exclaimed that seeing their patient disintegrate in quality of life and in overall health that it was difficult to not consider assisted suicide. Several participants came to a conclusion that their relative was strictly waiting to die because they had suffered enough which made them want to end the pain for them.

Letting Go by Atul Gawande provides an intriguing perspective on people’s stubborn expectations from the healthcare system. What should medicine do when it can’t save your life? Most everyone seems to believe they should fight to the bitter end, until they can’t possibly have anymore tubes coming out of them or medications going in. Gawande suggests that state of being is no longer living, so he raises the question of why people do it to themselves or their families. Gawande also provides the benefits of hospice care such as discontinuing medications. When patients stop fighting and start accepting the time they have, they gain more.

This is recognized to be an issue, and throughout the article the authors provided an understanding of how palliative care and end-of-life care are provided too late for a patient and should be provided at an earlier time in order to bring more comfort to the patients. The authors suggest that when and how end-of-life care is provided should be altered, with nursing ethics in mind, so that patients and nurses may feel better about the care they receive. This source will help my research by providing information on how changing the policies of end-of-life care and palliative care can result in the patient feeling a relief from their suffering and ultimately feeling more comfortable. This will also help my argument in how altering the current policies and focusing on providing better end-of-life care can lead to the diminishment of physician-assisted

Suffering is a constant companion of humans today; people experience it every day, whether it be emotional or physical, internal or external. Living with a terminal illness is also living with suffering, both because of the physical pain that is felt, and also the emotional blows the patient experiences every day. A terminally ill patient has a monumental part of their life taken from them. Few aspects of life still remain in their control, because of doctors, family members, and the illness itself. However, there is a practice that places a final decision, the right to choose the circumstances of death, with the patient. Physician-assisted suicide (PAS), or physician

Dr. Byock delves right into the sobering facts of death and that a large majority of Americas still die in

Kaufman was interested in knowing whether technology has affected the way patients died and the way they ensured a “death with dignity”. She defines “death with dignity” as a death that has been controlled by the patient since the beginning This means, that by the time of their hospital stay, the person has remained in control and is autonomous of all their life options, including their own medical decisions. In many cases, a “death with dignity” is also characterized as a “good death” or a death that has been exempted from both suffering and pain. Consequently, Kauffman was trying to understand why patients, and in some cases physicians and families, push for harsher medical treatment to extend life, even when this endanger their possibility of a “death with dignity”. After reading Reed’s personal memoir, I realize that neither patients or physicians are trying to hurt each other, when they push for harsher treatments.

What was once believed to be a form of neglect has resulted in a change in practice with the idea that doing less is more. Culture is an important factor in how care is rendered and thus, the limitations of palliative and hospice care lie within the desires of the family and patients. A thorough understanding of our surrounding demographics helps to ensure a seamless approach to providing care without bias or imposition of ones beliefs. However, just as with all things, providing care for the sick and comforting the dying should be rendered in moderation as to prevent the effects of burn out. Likewise, the same effects occur in the caregivers who sacrifice their responsibilities in order to care for their love ones. Finally, and with some closing thoughts, the writer wishes to express with gratitude the benefit of having taken this course to better understand oneself and others in the realm of healthcare. The lessons learned throughout have expanded this writer's knowledge and understanding of the human desire to make a connection through communication, emotion, compassion, and spiritually - the platform from which this writer wishes to continue seeking further knowledge and

This article begins by explaining that by allowing terminally ill patients to choose media aid in dying, it is part of shared ethical principles. These principles include the respect for autonomy and self determination of the individual. The decision about their own care ca be made by patients who are suffering as they are about to pass away.

(Schapira, 2010) It is important for patients to have all the facts in order to accept and prepare for death. Another area not always communicated well has to do with advance care planning. Many patients do not learn about options or talk about end of life issues until it is very late. Studies have shown that younger doctors are more likely to initiate conversations about end of life care options. (Pahwa, Babu & Bhatnagar, 2005)