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Surgery At The End Of Life: Reality Check

Wed, 10/12/2011 - 9:28am

The medical segment of Twitter is abuzz today over a paper by Atul Gawande and colleagues pointing out that almost a third of elderly Medicare recipients undergo an inpatient surgical procedure in the last year of their lives. Just over 18% have such surgery in the last month and 8% in the last week of their lives. The paper was published online in the journal The Lancet.

There is a lot to think about in this paper including the fact that there are marked geographic regional variations in the amount of surgery performed.

I’d like to focus on an issue that is not discussed enough, which is futility. In response to the flurry of tweets linking to the abstract of the paper, I replied that I felt that families (and sometimes patients) refuse to accept reality.

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