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Coronavirus shows us why the time to decide on end-of-life care is when you're not sick

Shiloh

Editor, Senior Moderator
Source: https://www.nbcnews.com/think/opini...hy-time-decide-end-life-care-when-ncna1178496

Coronavirus shows us why the time to decide on end-of-life care is when you're not sick
More than ever, this is time to have conversations you never wanted to have about what parts of living are most important to you.
April 8, 2020, 4:40 AM EDT
By Dr. Rita A. Manfredi, Dr. Breanne Jacobs and Dr. James P. Phillips

We are emergency physicians who work on the front lines battling COVID-19 in academic and community emergency departments — and we are worried. We hope to save every person struck by coronavirus (or any other affliction), but the nature of life is that, sooner or later, we won't succeed.

Limited supplies, like N95 masks, coupled with the possible need to ration resources, most notably ventilators, already haunts us. But the reality beyond the headlines is that, even if we could provide everything that every patient needed, it will often not be enough.

Physicians dedicate their lives to the treatment of illness and the prevention of death and, in conventional times, we do so without restrictions on materials or space because the resources we need are usually available in the American health care system. Those lifesaving resources are offered to all, even if the likelihood of a meaningful outcome is poor — including when it comes to ventilators.

The reality is that patients who require mechanical ventilation for any reason have high mortality rates, and those high rates increase with the age of the patient. That reality doesn't change when it comes to COVID-19. In fact, early data suggests that perhaps the majority of COVID-19 patients who require life support ventilators still succumb to the illness and die. Unfortunately a person who dies connected to a ventilator spends their remaining time alive sedated, with a plastic tube in their windpipe, and attached to a machine, unable to communicate with their loved ones....
 
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