Should doctors give patients' loved ones hope no matter the situation? Or should they allow loved ones to say goodbye when a situation seems hopeless? In Hope or Letting Go: The Final Good-bye.Dr. Anthony Youn describes why these questions have been haunting him for years.
While a junior surgical resident, Dr. Youn was involved in the emergency care of a man in his mid-30s who suffered burns over 90% of his body in an industrial accident. (identifying details are changed)
The patient's wife and young child arrived and were in the waiting room. Meanwhile, the patient's breathing became more labored. The attending surgeon felt it was time to put a breathing tube in.
Dr. Youn asked the surgeon if they should have his wife and daughter come in to say goodbye before intubating the patient .
His answer? "No...They don’t want to hear that. He’s in terrible shape and can barely speak. We need to give them hope.”
The patient died less than 24 hours later.
Youn asks if it's preferable for the wife to see her husband sedated and to hold onto hope that he might survive, or if it would have eased her loss to have had the opportunity to say goodbye (even if it meant seeing him in grave pain).
I find this story and his questions troubling. Should concern for loved ones' needs ever take precedence over patients' needs? Do patients who appear peaceful give loved ones more hope for recovery?