Whose body is it, Anyway

Whose Body is it, Anyway? ANNALS OF MEDICINE about medical advice to patients who make bad choices about their personal care… Writer tells about a patient he calls Joseph Lazaroff, who wanted an operation to remove a tumor from his spine… A biopsy showed an untreatable cancer… He had two options left. He could undergo spinal surgery. It wouldn’t cure him—surgery or not, he had at the most a few months left—but it offered a last-ditch chance of halting the progression of spinal-cord damage and possibly restoring some strength to his legs and sphincters… The alternative was to do nothing. He’d go home and continue with hospice care, which would keep him comfortable and help him maintain a measure of control over his life. The immobility and incontinence would certainly worsen. But it was his best chance of dying peacefully, in his own bed, and being able to say goodbye to his loved ones… Tells about a 1984 book, “The Silent World of Doctor and Patient,” by a Yale doctor and ethicist named Jay Katz. It was a devastating critique of traditional medical decision-making, and it had wide influence. In the book, Katz argued that medical decisions could and should be made by the patients involved… Lazaroff wanted surgery and wasn’t dissuaded by the risk… Tells about Lazaroff’s slow post-operative decline… He died fourteen days later… Writer describes examples of doctorly manipulation regarding medical care and tells about his daughter’s bout of apnea… He entrusted the decision for her care to other physicians… I needed Hunter’s physicians to bear the responsibility: they could live with the consequences, good or bad… It turns out that patients commonly prefer to have others make their medical decisions… Writer discusses medical ethics… As the field grows ever more complex and technological, the real task isn’t to banish paternalism; the real task is to preserve kindness… Tells about a patient who passed out after refusing a respirator, and who—when he eventually revived and began to recover—thanked the physicians who had intubated him anyway…

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