Do advance directives by healthy people actually deliver better care?
My patient had done everything possible to avoid being intubated. After a traumatic hospitalization when she was young, she had consistently told her loved ones that she would never again agree to a breathing tube. She had even filled out an advance directive years ago to formalize that decision.
But when she arrived in the emergency department one night this past spring with a severe pneumonia, struggling to breathe, the doctors called her husband with a question. Should they intubate? If they didn't, she would likely die.
He hesitated. Was this really the scenario that his wife, now in her late 60s, was imagining when she told him that she didn't want a breathing tube? He could not ask her now, and faced with this impossible choice, he gave the team the OK. She was intubated and sedated and transferred to our intensive care unit later that night.
I believed this to be a failure of our health care system: A patient was in exactly the scenario she had long wished to avoid. When I stood at her bedside, I murmured an apology... nyt
But when she arrived in the emergency department one night this past spring with a severe pneumonia, struggling to breathe, the doctors called her husband with a question. Should they intubate? If they didn't, she would likely die.
He hesitated. Was this really the scenario that his wife, now in her late 60s, was imagining when she told him that she didn't want a breathing tube? He could not ask her now, and faced with this impossible choice, he gave the team the OK. She was intubated and sedated and transferred to our intensive care unit later that night.
I believed this to be a failure of our health care system: A patient was in exactly the scenario she had long wished to avoid. When I stood at her bedside, I murmured an apology... nyt
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