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Striking a balance
In this paper, I am going to highlight emotional turmoil that may result from being highly invested in a patient during the end of life care. To this end, I will show how succumbing to excessive emotion attachment emanates from the unique circumstances surrounding a dying patient. Rather than condemning the increasing empathy in therapeutic relations, I will highlight its benefit with a caveat that it should be practiced with moderation. At the centre of end of life care is palliative care thus it will also be elaborated to aid in the understanding of the other concepts. In illustrating, the balance required between empathy and quality clinical outcomes, I will point out that the former and the latter are not binary but integral parts of the professional medical conduct. To overcome the innate ethical dilemmas and emotional drain consistent with end of life care all the members involved have to find equilibrium.
Contemporary society has taken great strides to revisit the old traditions that defined humanity; caring for the less fortunate as the onus of the entire society. The above progress is best exemplified in the medical arena and everyone should emulate it. In the previous centuries, the medical teams caring for patients were encouraged to distance themselves emotionally from the patients for the fear of becoming too attached (Abelson). The counsel demanded the relationship should be restricted to a professional level to optimize clinical neutrality. The proliferation of malpractice litigation has seen medical practice take an entirely different stand on the issue. The medical fraternity is even teaching empathy practices to facilitate a better patient clinician relationship. As a by-product of this evolution in patient care there has arose a branch called palliative care that entails treating the said patient with the intent of improving the quality of their respective lifes.
In palliative care, the clinicians care for the patient to alleviate pain and improve comfort outside the traditional curative methods. The patients are usually beyond salvaging using the above normal procedures, as the ailment afflicting them is usually malignant. The clinical team may decide to reduce the bulk of a tumor in a cancer patient to make them more comfortable rather than to cure them (Kuhse 261). Palliative care is at the core of end of life care. The said practice is not down by one doctor in isolation rather it is interdisciplinary soliciting the expertise of sociologists, psychologists in addiction to the usual ensemble (Glare, Paul, and Sinclair). The family also takes a more central role. The process aims to assist the patient to regain balance in the various spheres of their life. It has become commonplace to find about a hundred beds reserved for palliative care. Gone are the days when patients with malignant conditions were left to wither away in solitude or with their families if they were lucky.
The benefit of emotional connection is enjoyed both ways. The physician and his team have an increased accuracy of clinical outcomes owing to the knowledge of the various aspects of the individual. The clinicians may find meaning in their work (Glare, Paul, and Sinclair). The patient is more involved in the process becoming responsible for his health. The reduced pressure delays or reduces manifestation of physical symptoms. The empowerment of patients has been proven to increase the longevity of malignant cancer patients, as they believe the have a measure of control of their lives.
The prolonged proximity of patients and their caregivers may cause them to grow too attached becoming irrational. The caregivers may become too personal viewing the invalid as their child and them as parents. The fanatical empathy may manifest in either extreme of the treatment continuum. The team may insist on caring for the patient even when it does not make financial sense. The treatments are expensive and as there may be a point, where the available data and logic demand the attention be shifted to a person with a chance at recovery (Hartocollis). Conversely, the team may be too touched with the persons suffering that in attempt to alleviate his woes they advice him to pursue assisted suicide. If a patient dies in their care, they may be weighed with guilt that they did not do enough to save the individual’s life. The practitioners may regret “playing God” as they in conjunction with the family members decide the best way for the ailing man to die. Most prefer the less agonizing palliative sedation that aids hastens what they perceive as an inevitable death. The practice contradicts the spirit of the medical practice, to preserve life. The team may momentarily loose the sense of purpose they had gained. The meaning the patient had given to their benign endeavor. The issue with excessive emotional investment is that the fate of the patient becomes intertwined to the caretakers’ mood. When the practitioner looses hope, it may have a ripple effect on the entire team. Subsequently, the patient may read their expressions and loose the zeal to fight.
For the above set up to work seamlessly, a balance has to be struck. An excessively emphatic therapeutic relationship presents as the same impediment to quality medical outcomes as practitioner who is completely desensitized to patients’ sufferings. Empathy should be present but regulated. The term coined for this state is compassionate detachment (Kuhse 263). While there are defined protocols of handling diseases at earlier stages, end of life care is governed by abstract laws that adapt to each unique situation. The overarching law that allows facilitation of a smooth death is the intention for a good outcome and relief from present torment by the patient. The decision need not be unanimous as long as the kin have consented. The uniqueness of end of life care starts from choosing the recipient said palliative care among a ward of critically ill patients in the face of shortage of funds. The empathy inherent in professionalism dictates that a dying person should receive a heart transplant even if the chances of survival are below 10 percent.
The
benefits of emotional connection between caregivers and patients are present.
At their vulnerable state, the practitioners get to know the patient as a
person a loving father and husband thus the loss of such a person may have
profound effects on the care giving team. Palliative care is not subject to the
ordinary medical protocols owing to its sensitive nature. Striking a balance
between empathy and preservation of quality clinical outcomes is the
cornerstone modern medicine. End of life care is innately a paradox as it
contravenes multiple ethical codes for the greater good such as palliative
sedation. Emotional connections have their benefits hence should be cultivated
though to a degree. Palliative care incorporates expertise from various members
of the society. Finding a balance though challenging is necessary.
Works Cited
Abelson, R. “Weighing medical costs of end-of-life care.” The New York Times Company, New York (2009).Online.
Glare, Paul A., and Christian T. Sinclair. “Palliative medicine review: prognostication.” Journal of palliative medicine 11.1 (2008): 84-103. Online.
Hartocollis, Anemona. “Hard choice for a comfortable death: Sedation.” The New York Times (2009): A1.Online.
Kuhse, Helga. Bioethics: an anthology. John Wiley & Sons, 2015. Print.