29/04/2024
End of life care.
Dr. Mohiuddin Waseem
For all living beings on earth death is the ultimate reality. No one has escaped from it not even the Prophets. It is said when Angel of Death approached Prophet Moses and informed him that he was there to extract his soul Prophet Moses in anger slapped him hard. The Angel went back to God Almighty and informed Him that your servant does not want to die. God replied, ask Moses to put his hand on a cow the number of hair on cowhide under his hand will be the years added to his lifespan. Hearing that Moses realized that ultimately those years will run out too and agreed to his death as God intended on his appointed time.
Many of us do not realize this fact in our life.
Medical science though has discovered cures for many ailments and thus has been able to extend the lifespan of our fellow human beings but ultimately death remains the bitter reality. Honestly speaking despite many scientific advancements in last century we have not been able to add quality of life to our elderly population.
It is said coming events cast their shadows ahead of time. People with advanced incurable cancers and multiple organ failure know what lies ahead in coming days.
Thirty years ago during my ICU training I was taught the imminency of death in a patient can be predicted by counting the number of organ failure and designating 25% mortality for each organ involved.
It is important that patients should be informed about their illnesses and what to expect with the available medical treatment.
It is the responsibility of physicians to educate their patients and their loved ones the predicted outcome of their illnesses. Many patients consider comfort measures at home at end of life care instead of heroic medical treatment at hospitals.
Patients have the right to make any decision for themselves. As a fellow humans it is our responsibility to ensure their dignity.
(At American College of Physicians meeting, Boston April 2024)
"Follow the religion of Abraham, the upright one; and he was not of the polytheists" (Holy Quran 3:95).