When is medical treatment futile? ABC Health Report

Many doctors want to lift the lid on a phenomenon they say is worsening the suffering of many dying Australians. It's called 'limited benefit' or 'futile medical treatment', where patients with a poor prognosis are given aggressive drug therapy or surgery.  This special edition of ABC Radio National’s Health Report opened debate on this issue, and the possibility that many specialists are not considering palliative care early enough.

Dr Peter Saul, Senior Intensive Care Specialist and Ethical Consultant with the New South Wales Health Department discussed the problem of initiating a conversation with dying patients which includes “'do you really want us to do all of this and have you spoken to your family and what were your expectations' [which] becomes a very long conversation, whereas the 'sign here, we're going to operate' is five minutes.”   He believes that doctors don’t always tell patients the full story, but that they mean well and are not solely responsible for the problem of aggressive treatment being given to uninformed, dying patients.  “My own personal view is that Australia is a very, very death-denying society and that this discourse doesn't take place very much.”

Dr Steve Hambleton, President of the AMA, agreed to a certain extent, "When we present options to patients there is a tendency to ... talk about the people who do survive, not really about the reality  So we do tend to put things in a very optimistic way and we need to be realistic, and some people are going to reach that long tail, the survival tail, but the majority won't."  

The program includes interviews with other specialists, including those in palliative medicine, and also covers the legal and ethical viewpoints on this debate.  The link above will take you to the transcript or podcast, or you can listen online.