fundamentals
Treatment Options at the End of Life
Introduction
Often, the available choices for end-of-life care involve a decision whether to accept the likelihood of dying sooner but to be more comfortable or attempt to live slightly longer by receiving aggressive therapy that may increase discomfort and dependence. For example, a person dying of severe lung disease may live longer if placed on a mechanical ventilator (a machine that helps people breathe). However, most people find being on a ventilator very unpleasant and often require heavy sedation. Some dying people and their families feel that they must try any treatment that might prolong survival, even when hope for gaining more than a little time is unrealistic. Such treatment often sacrifices the person’s last few days to side effects without gaining quality time, causes discomfort, entails substantial costs, and burdens family members. In many cases, as a person nears death, the focus of care should shift entirely to providing comfort measures to ensure that the dying person does not suffer and has every opportunity to experience the closure that honors the life lived. Personal philosophy, values, and religious beliefs become more important when such decisions are made by and for a dying person. 