{"id":47352,"date":"2020-04-30T10:56:56","date_gmt":"2020-04-30T09:56:56","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=47352"},"modified":"2020-04-30T10:56:56","modified_gmt":"2020-04-30T09:56:56","slug":"helgi-johannsson-lets-talk-about-death","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/04\/30\/helgi-johannsson-lets-talk-about-death\/","title":{"rendered":"Helgi Johannsson: Let&#8217;s talk about death"},"content":{"rendered":"<p><span style=\"font-weight: 400\">Every anaesthetist and intensive care doctor will have wondered if they did the right thing by taking someone to the intensive care unit.\u00a0It is often the &#8220;easier&#8221;\u00a0thing to do when faced with someone critically ill who is not in a condition to make an informed decision, especially when their family is not aware of what their wishes would be in this situation, and is very determined for us to try \u201ceverything\u201d for their loved one.\u00a0We end up taking over their breathing, inserting tubes and lines, and embark on a treatment plan that we know they have\u00a0a very slim chance of surviving at all, and no chance of getting back to a level that they would have been happy with if they had had the chance to have that conversation with their family.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In the last few weeks, the way we work has changed radically.\u00a0We are in the middle of a pandemic, and we are seeing infected patients come in critically unwell, needing urgent care, but without the benefit of having their family around them due to the danger of infection.\u00a0Family members are not allowed to come to the bedside where we are working to try to save their life, and it is extremely difficult for us to enter and leave due to the need for protective equipment to prevent us from catching the virus.<\/span><\/p>\n<p><span style=\"font-weight: 400\">There comes a point where we are certain that our efforts will not save our patient\u2019s life, and to continue treatment is simply adding to their pain and distress.\u00a0We discuss this with their family who may not appreciate how unwell they are, as they cannot visit.\u00a0This is a conversation we would never normally have over the phone\u2014it requires so much tact, empathy, and care to do it well, and it is so much easier to convey the information required face to face.<\/span><\/p>\n<p><span style=\"font-weight: 400\">It is nobody\u2019s wish to die on an intensive care unit, and most of the patients we treat will have thought about what they would want and when they would want their treatment to stop.\u00a0Most people will have shied away from having that conversation\u00a0with their loved ones because they don\u2019t want to be morbid, upset themselves, frighten their loved ones, or there\u2019s never really been the right time.\u00a0I want to ask you please, make now the right time.\u00a0Have this conversation with your family and let them know how you feel.\u00a0It is the greatest gesture of love you can give them, and will make their discussions with us so much gentler and easier.<\/span><\/p>\n<p><strong><i>Helgi\u00a0<\/i><\/strong><b><span style=\"font-weight: 400\"><i><strong>Johannsson<\/strong> is a\u00a0<\/i><\/span><\/b><i>Consultant Anaesthetist, RCoA\u00a0<\/i><a href=\"https:\/\/www.rcoa.ac.uk\/dr-helgi-johannsson\"><i><span style=\"font-weight: 400\">Member of Council<\/span><\/i><\/a><\/p>\n<p><em><strong>Competing interests<\/strong>: None declared<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Every anaesthetist and intensive care doctor will have wondered if they did the right thing by taking someone to the intensive care unit.\u00a0It is often the &#8220;easier&#8221;\u00a0thing to do when [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/04\/30\/helgi-johannsson-lets-talk-about-death\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":42063,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-47352","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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