WCOE: Amy Berman’s “Less Is More” Approach and End of Life Care

In the May 22nd Health Affairs online blog, “Living My Life My Own Way,” Amy Berman writes about what she knows firsthand and what she has learned from many years of professional experience.  And she writes and speaks about it so well, which is one of her many gifts.  She was diagnosed with inflammatory breast cancer in October 2010, and instead of a “typical throw-everything-at-it approach,” as she describes it, she chose a “less is more” approach, with quality of life as the focus. In sharing her story, she has made a huge impact on the dialogue of palliative care and the importance of making treatment decisions that respect an individual’s values and preferences.

Also released this week was a study, which complements Amy Berman’s blog and affirms that hospital-based intensive care at the end of life is something most of us would want to avoid.  The study suggests that physicians have a strong personal preference to avoid high-intensity care for themselves at the end of life and raises questions about why doctors provide care to patients that is not consistent with what they want for themselves or what patients want. We often hear from physicians that they don’t want to deny hope for their patients or feel like they are “abandoning” them as their quality and length of life becomes jeopardized by a diagnosis like cancer.

We need compassionate, communicative physicians who can deliver care without feeling like they are abandoning their patients. Indeed, these physicians can offer patients compassion and the truth about their diagnosis and prognosis, without robbing them of hope.