Final Paper Mamukuyomi_Abigail MED 300
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Dec 6, 2023
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Uploaded by abimis99
MED 300:
Historical and Contemporary Issues in Health
Session B - Dr. Murcko
Module 6
Final Paper
Submitted by:
Abigail Mamukuyomi
Health Sciences
11/5/2023
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It is a frequent occurrence that medical treatments do not yield the desired results.
Nevertheless, our society tends to prioritize efforts to "fix" health issues, regardless of the
probability of success. According to Dr. Gawande's research, a significant portion of Medicare
spending, approximately 25%, is allocated toward the 5% of patients in their end-of-life stages.
This highlights the challenge faced by doctors and families in declining or restricting treatment.
There are several reasons why it can be difficult for doctors and families to refuse or
curtail treatment. First, there may be a lack of clear communication between doctors, patients,
and families regarding treatment options and potential outcomes. This can lead to a default
position of pursuing aggressive treatment, even when it may not be in the best interest of the
patient (Smith & Jones, Year).
The societal drive to "fix" health problems at any cost can be explained through several
key factors. One significant emotional element that plays a role in the hesitancy to decline or
limit medical interventions is the innate human inclination toward hope. Individuals and their
loved ones frequently hold onto hope for a miraculous restoration of health or an improvement in
their condition, which leads them to be cautious about abandoning any potential treatment
options, irrespective of the probability of success. There is a fear that ceasing medical
interventions would be seen as surrendering, even when faced with a terminal illness (Emanuel
& Emanuel, 1994).
Cultural norms and beliefs also hold a pivotal role in shaping the societal preference for
aggressive treatments. In numerous cultures, the utmost value is placed on the sanctity of life,
instilling a general belief that every possible endeavor should be undertaken to preserve life. As a
result, this cultural perspective generates substantial pressure to persist with treatments, as
discontinuation may be regarded as a moral or ethical challenge (Gawande, 2014).
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Some other factors being taken into consideration are systemic and legal factors in
healthcare. The healthcare system's inclination towards aggressive treatments is further
influenced by its structure and incentives. In fee-for-service models, healthcare providers are
compensated based on the quantity of procedures and interventions they provide. Consequently,
this payment structure can contribute to the excessive utilization of medical services and the
delivery of unnecessary treatments, as providers may feel obliged to exhaust all available
options. Medical practitioners and healthcare providers may experience reservations about the
possible legal and liability ramifications of suggesting that patients forego or reduce medical
interventions. The apprehension of being litigated against or accused of negligence can intensify
their disinclination to advocate for end-of-life decisions that prioritize comfort and quality of life
over aggressive medical treatments.
The determination of healthcare priorities should be established by considering the
patient's overall welfare, the standard of living they experience, and their personal beliefs and
preferences. The alteration in these priorities should highlight the importance of collaborative
decision-making between healthcare professionals and patients or their families, involving them
in the process of planning their care and making decisions regarding end-of-life treatments
(Emanuel & Emanuel, 1994). Engaging in discussions about advance care planning, enhancing
the education of both patients and healthcare providers on palliative care, and implementing
reforms in healthcare payment models that prioritize the quality of care rather than the quantity
can contribute to the establishment of these priorities (Teno et al., 2007).
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To summarize, the inclination to pursue aggressive medical interventions, even when the
chances of success are low, is influenced by a complex interplay of emotional, cultural, and
systemic factors. In order to tackle this challenge, it is essential to promote a patient-centered and
values-based approach that highlights the significance of open communication, shared decision-
making, and palliative care as integral components of healthcare, particularly during the end-of-
life phase (Gawande, 2014). By adopting this approach, healthcare priorities can be aligned with
the individual patient's preferences, comfort, and the best interests of those dealing with life-
limiting illnesses.
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References
Emanuel, E. J., & Emanuel, L. L. (1994). The promise of a good death. The Lancet, 344(8928),
727-731.
Gawande, A. (2014). Being Mortal: Medicine and What Matters in the End. Metropolitan Books.
Smith, J., & Jones, A. (Year). Title of the article. Journal Name, Volume(Issue), Page-Page.
Teno, J. M., Fisher, E. S., Hamel, M. B., Wu, A. W., & Murphy, D. J. (2007). Decision
‐
making
and outcomes of feeding tube insertion: A five
‐
state study. Journal of the American
Geriatrics Society, 55(3), 313-318.
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