A wonderful article just published by Chris Feudtner, who dissects a phrase that we hear all too often. ‘I want you to do everything’. He examines what families mean when they say this, and how we might respond as medical professionals. As he explains we can’t ‘do everything’ as everything includes therapies that may be themselves in conflict, or harmful or ineffective. Families will often mean that they aren’t ready to give up, they don’t want to withdraw or limit active care, and if there remains a flicker of hope for survival they want us to follow it. He particularly states that we should refrain ourselves from using the term as it is ‘dangerous nonsense. If we really don’t mean it, then we really must not say it. A moratorium is warranted, halting all medical personnel from further casual utterances of “do everything” ‘.
Chris writes very well; clear, thoughtful and stimulating. I would also recommend his article from 3 years ago in the New England Journal, ‘the Breadth of Hopes‘, which addresses some of the same issues, of examining what families hope for, and finding common, realistic hopes that we can share.