Feature Archive

Who Gets the Last Say?

Opinions vary on the right time to end aggressive treatment.

WebMD Feature

As the director of the intensive care unit at Memorial Sloan-Kettering Cancer Center in New York City, Jeff Groeger, MD, often cares for patients who have been told they have little time left to live.

Once the bad news sinks in, he must help them decide whether they should choose the most aggressive medical treatment available. "It stinks," he says -- meaning the emotional drain on both health care providers and loved ones.

It's also a complicated process. Everything from the patient's age, to the chances of surviving aggressive treatment, to his or her wishes for end-of-life care must be taken into account.

Such difficult decisions will become more commonplace. The number of aged in America is growing at an astounding pace, and controversy is building over how to treat those who are sick.

Some believe elderly patients should not be put through aggressive treatments because they are less likely to survive the heroic efforts. But others believe a bias against the elderly may lead to beneficial care being withheld.

Studying Survival Rates

Now a new study on the relationship between age, intensity of treatment and survival of serious illness has yielded some interesting findings. Researchers at five teaching hospitals across the country looked at 9,105 patients, aged 18 to 100, who were hospitalized with serious illnesses. They looked at the connection between age and the likelihood of survival six months later -- and especially at whether the intensity of the treatment affected the outcome. After six months, more than half the patients were still alive, according to Mary Beth Hamel, MPH, MD, the lead author of the study and a researcher at Beth Israel Deaconess Medical Center in Boston.