Peter K. Kim, MD, a surgeon at Albert Einstein College of Medicine, in New York City, faced a surgical dilemma: to treat or not to treat? An 80-year-old man had come to the hospital from a local nursing home. He had dementia. His body was covered with necrotic pressure ulcers that needed to be debrided. One fetid foot required amputation.
Dr. Kim sat down with the man’s son to discuss treatment options. Dr. Kim explained that operating on the man’s father wouldn’t change the big picture. Performing surgery would mean removing the patient’s foot and cutting all the dead tissue from his ulcers, but he was going to die soon regardless of the treatment he received. Treatment no longer signified a decision between life and death; it was a decision about how to die.
“This kind of ethical dilemma comes up almost every day for me,” Dr. Kim said. MORE