When Less Is More: Weighing the Consequences of Actions

I was supposed to see a 99 year old man on my schedule. He had been sick for a few weeks with intestinal issues. Initially the doctors tried to treat him conservatively. He did not get better.

His family decided he should have surgery. He was taken to the operating room and made it through the surgery but in critical condition. He ended up in the ICU after the surgery. He was given fluids, pressers and multiple blood transfusions. Ultimately his body gave out and he died the night before I was supposed to see him.

Modern medicine affords so much technology and intervention. But is it always the right thing to do?

This man could have spent his remaining time comfortable and surrounded by family. Instead he rounded out his 99 years in a freezing operating room and ICU probably in pain and surrounded by strangers. 

Sometimes less is more and allowing people dignity is the humane treatment.


  1. It can be incredibly hard for a family to let go, even of a 99 year old. There's a survivor guilt that folks have over not having done everything from the standpoint of heroic medical efforts. It can provide false consolation to conclude your loved one had an awful ending, but at least you know the team tried everything.

    Your post perfectly points out how once you change the frame of reference for people to: Have you done the right thing from the standpoint of dignity? the answer changes.

    Wish more people would apply your advice at the clinical crossroads...




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