STOP, LOOK AND LISTEN:
HOW TO AVOID BECOMING A
MEDICAL ROBOT
Suzanne McGee, MD
A
t University Hospital, the CT scanner is affectionately and jokingly
known as “the physical exam machine.” Using that machine literally gives
us x-ray vision into our patients’ bodies in
exquisite detail. It can help us clench a diagnosis that we couldn’t quite prove without it.
However, sometimes we learn more about
our patients’ insides than we ever wanted to
know, finding “incidentalomas” that patients and their doctors had
not suspected but now have to consider. Doctors need to be wise
stewards of this blossoming array of medical technology, without
overusing, remembering radiation exposure as a lifetime risk. We
need to be just as cautious with this plethora of technology and
information as a police officer would be with a gun, a jeweler with
a five-carat diamond, or a parent with his/her child. This is where
I think we sometimes fall short as doctors.
Technological advances in every specialty of medicine have enabled patients to live longer, healthier lives. Many people are able to
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live satisfying, productive lives with diagnoses such as HIV/AIDS,
various cancers, rheumatologic diseases and heart failure, scourges
that previously would have ended their lives prematurely. However,
sometimes this plethora of technology and innovation opens a
Pandora’s Box of ethical dilemmas for physicians.
There have been times that I’ve felt that technology has hindered
patient care and has made “death” a dirty word. I have encountered
patients with life altering, incurable disease processes who are kept
alive with dialysis, ventilators, feeding tubes, ventricular assist
devices and every sort of medication one could imagine. Their
bodies become exhausted by the robotic-like interventions that are
keeping them alive and they become shells of the people they once
were. I respect patients’ and their families’ decisions to choose full
interventions in such situations, but I feel it is absolutely imperative that their doctors understand and explain the implications to
patients and their surrogate decision makers while still respecting
their decisions. Patients have the right to be kept alive at all costs,
but they also have the right to say “enough is enough” when means
to keep them alive are extraordinary, and there is little to no hope