Samir K. Shah, MD
Requests for Single Reprints: Samir K. Shah, MD, Department of General Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk A100, Cleveland, OH 44195; e-mail, firstname.lastname@example.org.
Shah SK. Futility. Ann Intern Med. 2014;160:138-139. doi: 10.7326/M13-1050
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Published: Ann Intern Med. 2014;160(2):138-139.
In this era of increasingly cost-conscious health care, there has been much discussion about end-of-life care. The statistics behind the disproportionate expenditure in the terminal months of life and the accompanying dismal clinical outcomes have become a staple of any presentation on the topic. Although this sort of fine economic and policy analysis has provided insight into the problem, it neglects an essentially human barrier to avoiding futile care, a problem that was brought home to me as a resident on a recent surgery call.
The consult for Ms. K came late at night. It was from the cardiac surgery team for evaluation for abdominal sepsis, but I soon discovered that the actual story was far from straightforward. Ms. K was a woman in her 50s who had initially developed epigastric pain and used a roommate's pain medication and hypnotics to blunt the discomfort. The pain did not decrease, and she took escalating doses of medications. Ultimately, Ms. K became stuporous and so obviously and severely ill that her roommate called an ambulance.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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