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By Sheldon Z. Goldberg
a. That means optimizing the outcome
i. preserving the highest quality of life
ii. For as long as possible
iii. Optimizing the quality of life when prolongation is no longer possible
iv. Sometimes it means a good death.
a. RSS feed
b. Look it up forevery patient, no matter how familiar it feels
a. With the patient
i. Phrasing is important
1. we all need hope
b. With the family
c. With myself
i. Am I doing my best at all times?
a. Sometimes shrinking a cancer is not a good investment for the patient.
i. The treatment can lower quality of life
ii. Sometimes, the treatment can shorten life.
b. Research can emphasize the impact on the disease to the exclusion of impact on the patient
a. Sparing the patient side effects is sometimes the best thing the doctor can do.
a. More intensive, ineffective treatment is not good care
b. The most dramatic therapy has the same burden of proof as any other therapy
c. Sometimes a clinical trial is the most appropriate path
i. But evaluate all of the alternatives