Medicine: Ethnic disparities in medical treatment at the end of life

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News from the World of Medicine
  • 2017 11 Medicine, Ethnic disparities in medical treatment at the end of life
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Treatment in the last 30 days of life is different for black Americans and white Americans. Multiple studies have shown that black patients receive more “aggressive treatment” at the end of life.
Beyond the ethnic differences: Doctors have trouble talking about end of life to patients who are dying. Doctors often give patients who are dying “aggressive treatment,” i.e. too much treatment, and that can be stressful. In the last 30 days of life, 1 in 2 patients is admitted to an emergency department, 1 in 3 patients is admitted to an intensive care unit, and 1 in 5 patients has surgery. And some cancer specialists give chemotherapy to patients who are dying just to avoid a discussion about dying.
My advice: If you should be diagnosed with cancer someday, do not be afraid to ask: “What is the goal of my treatment?” If the answer is “Improved survival, but only by a maximum of 3 months, or even less” or “Improved survival is not possible,” do not be afraid to say: “I want to know the common side-effects of this treatment, so that I can decide for myself if it is worth it, for me.”

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