Hope to achieve balance between the reality of planning a dignified death

Dealing with end of life decisions and the accompanying critical challenges for all parties concerned of the patients, families, friends and doctors. In fact, the "management" of the progress to death, especially when the diagnosis was urgent, and can be a very complex process. The challenge for all who participated often in a different way.
Networking is the first goal, and should start with the doctors. In their role, and doctors are often responsible for bridging the gap between life and improve rescue care, so I usually struggle to balance hope with reality. Determine "the amount of information", "at this time" and "with any degree of openness of this particular patient," requires a commitment of skilled to mature with age and experience.

Medical advice should be very personal, and must take into account the diagnosis, the risks and benefits of different interventions, and the burden on the patient's symptoms, before the timer, age and stage of the patient's life, and the quality of the support system of the patient.

At the same time, it is common for the patient and his family narrowly focuses on the preservation of life, especially when it is for the first time of diagnosis. They must also cope with the trauma, which can lead to complex analysis, which reflects in many cases, with regret, guilt and anger. Must be run from the fear and channel it. Perhaps this stage of confusion persist for some time, but a sharp decline, and the results of diagnostic studies, or the presence of an internal awareness usually refers to the transition, and leads patients and their relatives to recognize and finally understand that death is near.

Once acceptance occurs, take the decision to terminate life, of course, makes the following. Rejected this approach, the continuous pressure of death only on the timing of these decisions, he adds, anxiety, and undermines the sense of control over his fate.

With acceptance, and become the ultimate goals of quality of life and comfort for the rest of the days or weeks or months. Doctors, and can be palliative care, family and other care providers focusing on the evaluation of symptoms of the patient's physical, psychological and spiritual needs, and determine the purpose of life goals. How can that be important for the patient to attend a wedding or see the festival granddaughter last Christmas, and these goals and realistic to continue?

Planning for death with dignity, we must recognize death as part of the life experience to be built instead of ignored when it comes. And will be ready?

Mike Magee, MD, is Senior Fellow in the Humanities at the World Medical Association, director of the initiative, Pfizer Medical Humanities, and the host of the weekly policy Webcast Health "with Dr. Mike Magee."