Experience and the continuously improving prognostic scoring systems have not always helped physicians to absolutely predict the outcomes of terminally ill patients. As a consequence, clinicians can only estimate of chance of survival of the patient based on their professional judgement. On the other hand, most families in the United States have high expectations about medical care in general and intensive care in particular. As a result, an insignificant chance of survival is still worth the wait for a miracle in many families. For this reason, clinicians should be a friend and the trusted counselor to families and patients. Clinicians should respect patient’s autonomy. Physicians have a responsibility of carrying out patient’s requests in a compassionate manner. For example, if a patient is suffering in a terminal state and wants some analgesic to relieve his or her pain, it is justified to carry out this request even when physicians know that this will reduce the lifespan of patient. In order to do that, physicians should provide professional recommendations regarding the alternative medical choices based on their professional judgment of both patient’s medical situation, values and goals of treatments. Recommendations, with respect to patient autonomy, should help the patient or family members make a decision as voluntarily as possible. However, health care providers also hold the stewardship of health care resources. Consequently, physicians may have a right, in some states, to intervene and withhold or withdraw a life-sustaining support without the consent of the patient or surrogate if the intervention is judged to be futile. In this scenario, patients or families should have their “cognitive empathy” with their physicians or with other terminally ill patients because they also need hospital beds
Experience and the continuously improving prognostic scoring systems have not always helped physicians to absolutely predict the outcomes of terminally ill patients. As a consequence, clinicians can only estimate of chance of survival of the patient based on their professional judgement. On the other hand, most families in the United States have high expectations about medical care in general and intensive care in particular. As a result, an insignificant chance of survival is still worth the wait for a miracle in many families. For this reason, clinicians should be a friend and the trusted counselor to families and patients. Clinicians should respect patient’s autonomy. Physicians have a responsibility of carrying out patient’s requests in a compassionate manner. For example, if a patient is suffering in a terminal state and wants some analgesic to relieve his or her pain, it is justified to carry out this request even when physicians know that this will reduce the lifespan of patient. In order to do that, physicians should provide professional recommendations regarding the alternative medical choices based on their professional judgment of both patient’s medical situation, values and goals of treatments. Recommendations, with respect to patient autonomy, should help the patient or family members make a decision as voluntarily as possible. However, health care providers also hold the stewardship of health care resources. Consequently, physicians may have a right, in some states, to intervene and withhold or withdraw a life-sustaining support without the consent of the patient or surrogate if the intervention is judged to be futile. In this scenario, patients or families should have their “cognitive empathy” with their physicians or with other terminally ill patients because they also need hospital beds