In response to “How to Approach End-of-Life Care Discussions, Determine Treatment Goals for Patients Near Death in the Emergency Department,” May 2014] The conversation changes completely if one uses “allow natural death” in the family discussion instead of the clinical terms “no CPR,” “do not resuscitate,” “no code,” etc.
I have had patients and families respond as if all the weight in the world was lifted from their shoulders when I have asked, “If while you are here in the hospital your heart or breathing stops and you die a natural death, do you want us to do anything about that?”
The usual response, no matter what their advance directive may say, is, “Oh, no. I’ve always wanted to die a natural death, not hooked up to any tubes or machines.”
There’s a wealth of resources on this available. Just search for “allow natural death.”
–Chuck Pilcher, MD, FACEP