In A Difficult Position

I think many of us have been a difficult position before. It could be situations where you have to tell your mum that you broke her treasured vase, or situations where you have to tell dad that you drove his car into the back of another vehicle, or situations where you end your relationship with your boyfriend/girlfriend...etc...there are just so many situations that one could think of, that would place a person in a very difficult and uncomfortable position.

As a doctor, I think the most difficult situations I have faced so far is telling a patient that he or she is dying, or telling their loved ones that the patient is not going to pull through much longer. The other thing I find difficult is the decision making involved in the care of a dying patient. At what stage do you decide that you want to withdraw treatment and just keep the patient comfortable? And when you decide to take away all treatment, you are more or less "sending" the patient to his or her death. But then again, if you continue treatment, you are just prolonging the patient's suffering....and is that justified? Is that fair to the patient? This is tough.

A couple of days ago, I was left in another difficult position. A patient was terminally ill with cancer. To complicate matters, this patient was under police custody and have to stay in prison for a couple more weeks. Now, although I have never lived in the prison before (in fact, I sure hope I won't be at that stage one day), I am aware that it is not comfortable. The environment is gloomy and cold. It is certainly not the best place for a person who only has a couple more weeks to live. But at the same time, I can't allow him to stay any longer in the hospital given that we have treated what we could. It felt cruel sending the person back to prison. My colleague put this thought into my head, "It is unfortunate that the patient has cancer and is dying, but the patient commited a crime which led to imprisonment."

I guess she has a point. However, I couldn't help feeling sorry, but at the same time, I have to do my duty as a doctor, and discharge patients when necessary, to allow medical treatment for other patients.

I rest my case.