“Never withdraw care”

We should never really withdraw care.

This was a quote from a fabulous talk I went to today about communication.

It is true.

In medicine, we often say things like “withdrawal of care” and mean things like withdrawing life support or stopping “extreme” or “heroic” measures.  Sometimes it is even about things like stopping active treatment for incurable disease.

Taking those things out of the picture does not equate not doing appropriate supportive care.  Everyone needs supportive care.  Always.  Just in different ways.

But, if you are a family member, it can sound like you are taking everything away.

Like the health care professionals don’t care.  Like hope is gone.  Like they are being left to die.

That is where this quote came in.  How the language we use can really portray the wrong message.  Context is everything, but really, we need to try to keep context out and keep things clear.

And no matter what, we should still care.   It is in the term healthcare.  It just makes sense to care in medicine.  Medicine is a caring profession. Because sometimes caring is all you can do.

Care is always in the equation.  The definition of care is what can change.

Sometimes the most caring thing you can do is to stop intervening beyond basic symptom management and emotional support.

It isn’t giving up, it isn’t even always changing focus.  It is about context.  It is about our humanness.   It is about care at the root of the word.

Just some food for thought.

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4 thoughts on ““Never withdraw care”

  1. We have stopped calling it withdrawing care in my areas hospitals. When a patients family or condition brings us to the end of treatment, we say that they’re being transferred to “comfort care”. It seems like it’s better received then “end of life care” or hospice.

    • I think it is smart to not call it withdrawing care. In fact, choice of words is so important in these sorts of situations! I don’t think it is commonly called withdrawing care here, however, the term still gets thrown around by certain people.

  2. We still use the term “palliative care” and I think it still has the same connotation to a lot of patients as “withdrawing care”. While it is “end of life care”, I often explain to patients that it is more about the process of dying than dying itself, if that makes any sense. Still, it’s a difficult concept to grasp for many.

    • “Palliative care” is the most common term used in my area too and people often see it as a death sentence when the words are uttered. I like to introduce the team and unit as the pain and symptom management team, talk a bit about what they do and when they do it and that they also are called “palliative care.” And like you, I try to explain that it is more about process and caring for the illness in a different way.
      It can be such a frightening experience. And our word choices really aren’t the best. And connotations have amplified the issue.

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