What is happening?
The patient, Doris, has advanced ALS. Due to the muscle weakness associated with the bulbar nerves, the patient can no longer speak or swallow. The patient is worried about being a burden to her family and how she might die. Through a written note, the patient requests the physician to hasten her death and make it fast and patient (Patient’s Video Discussion).
What issues does the video raise? (Patient’s Video Discussion)
The video raises end-of-life issues involving the patient, the physician, and the family. The patient feels like a burden and expresses her fear and worry. The underlying issues range from being unable to express herself verbally, to pain, and uncomfortable. The video also highlights the importance of involving the family. In scenario 2, involving the family helps the family member answer the patient’s concerns about being a burden.
The family’s engagement is also critical to the patient as it shows the support and love she gets from the family. The video also raises the issues of when and under what circumstances the doctor respects the patient’s end-of-life wishes. The video also highlights non-judgmental open listening as a way in which one could address issues of suffering and determine ways of reducing the suffering (Patient’s Video Discussion).
What emotions come to your awareness for you, the doctor, the patient, or the family?
The patient is facing fear and worries about dying. She also feels uncomfortable due to pain and the challenges she faces with breathing and movement. The family is supportive and engaged with her treatment. They are present and hopeful that she will recover. The doctor is also supportive and reassuring. She shows empathy by using ‘I understand’ and engaging the patient in reducing pain and making her more comfortable.
Pallium Canada. (2012). Discussing Goals of Care (Hasten Death Request) (PDV008) – 2012 update [Video]. YouTube. https://www.youtube.com/watch?v=jXmqsz7dn4A