In their paper, “Should Physicians New to a Case Counsel Patients and Their Families to Change Course at the End of Life?” Shyoko Honiden, MD, MS, and Jennifer Possick, MD, describe a case where two physicians disagree on a treatment plan for a critically ill patient with stage IV non-small cell lung cancer. Originally, the patient was considered a candidate for a clinical trial with a novel treatment that showed positive results, but after a few weeks of declining health, acute respiratory distress, and other illnesses, the patient’s condition had deteriorated rapidly. The first physician and the family agreed to transfer the patient to hospice care. A second physician, new to the case, disagreed with this treatment plan.
What can be done when physicians disagree on end of life decisions? The pair discuss physician practice variation and how to resolve a conflict between physicians when they disagree on end of life care. They advocate for use of the shared decision-making model, where respect for the patient is paramount, and well-informed decisions and dialogue between physicians and the family is critical.
Read the complete commentary in the AMA Journal of Ethics.