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Friday, August 26, 2016

Small-town mayor with pancreatic cancer feels ‘betrayed’ by health system | Toronto Star

Paying for hope. As a health care fiduciary, this is one of the trickier waters to navigate because your doctors never want to remove hope but we do have to be honest. What to say to the patient who has a terminal illness and has exhausted first line therapy, second line therapy, salvage therapy and even experimental therapies, but desires to battle on to find a cure? The picture is further confounded by some who will gladly take these patients' money with the promise of being able to offer what no one else may. The practice referred to as the "wallet biopsy" meaning as long as the patient or their insurance is willing to pay, there is never a no to ongoing "treatments". On the flip side of the coin, who are we to tell a patient they cannot pay for hope? Is that such a bad way to spend one's money--worse than spending it on shoes, or a trip, or a new car? But the latter argument introduces a slippery-slope of potentially unethical substituted decision-making by those who are not you, the patient. Challenging...let me know if you have any insights for me.
from Rajesh Harrykissoon, MD

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