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12/14/2017

Palliative Care vs Just Busine$$

Here is a true story of a decision made by the patient and his opthalmologist to allow a terminally ill patient who is expected to die soon and who has cataracts in both eyes to have cataract surgery to be able to see his family before he dies. 
The story is described at the National Public Radio website
https://www.npr.org/sections/health-shots/2017/12/03/565683105/should-eye-surgeons-fulfill-a-dying-mans-wish-to-see-his-family

 Should this decision be subjected to debate as an ethical issue? For example, the opthalmologist involved, who wrote the article, stated:
Our anesthesiologist and others on the operating room team were opposed to performing a surgery on a patient on hospice with only weeks to live. The anesthesiologist was trained in Britain and noted that Thomas’ cataracts would never be removed there, where committees decide on the utility of certain treatments and procedures. For someone who would only get a few weeks of “use” out of his surgery, the costs couldn’t be justified. Thomas’ oncologist was concerned about his health and had a serious discussion with him. However, Thomas understood the risks and decided it was worth it to undergo the surgery.

The title of this thread sets the ethical issue: was the decision to perform the cataract surgery based on the patient’s desires simply a matter of palliative care to those terminally ill such as procedures and medications to relieve pain all of which is accepted as ethical medical management?  Or could this decision be considered an unacceptable procedure under these clinical circumstances with the only financial gain? Or as the ophthalmologist author asked the reader:

So were we right to perform this surgery? Or were we greedy doctors, only out for the bottom line, driving up the cost of medical care in this country? We see a cataract and need to take it out even though a patient is dying? 

So I look forward toward your Comment regarding this unique dilemma.  ..Maurice.


Graphic: Google Images

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