According to his advanced directive, the legal document that allows one to outline decisions about end-of-life care, the patient did not want to continue with additional tests or procedures. So, it was agreed he would be better off spending whatever time was left at home, surrounded by loved ones, rather than in a hospital undergoing procedures that would not improve the quality of his life.
In the minds of many physicians, it can sometimes come down to whether they are offering life or prolonging death. It’s not always an easy decision and often requires difficult choices in trying to address the person’s wishes and avoid futile tests and interventions.
The Dartmouth Atlas Project, led by the Robert Wood Johnson Foundation found that people with severe chronic illness who live in communities where they receive more intensive inpatient care do not have improved survival, better quality of life, or better access to care than patients who live in communities where they receive less care. These patients, however, receive a much more aggressive brand of medicine, see medical specialists more frequently, spend more days in the hospital, and die in an ICU more often than those in lower intensity regions.
That’s why an advanced directive can make a big difference in making sure one’s end-of-life preferences and wishes are known to loved ones and physicians.