Emilio Gonzalez, Leigh’s disease, and futile care

Listen to this New England Journal of Medicine interview between Rachel Gotbaum and Dr Robert Truog on healthcare and futility, including the case of Emilio Gonzalez, a baby with Leigh’s disease, a progressive neurometabolic disorder. Truog makes the interesting case that sometimes it’s best to do what families want, even if providers don’t think that’s what’s best for the patient.

When families would have wanted less vs more care

Watch this video from ABC Australia showing the range of preferences from the sister of an adult with laryngeal cancer to the parent sof a child with a brain tumor. Sometimes providers avoid discussions of impending death by continuing to offer treatments that are unlikely to offer significant benefit to the patient. Other times, families would literally rather die trying versus switch to a more palliative care route.

Do doctors have to do everything?

Listen to/watch this chalk talk of Rich Gordon and Dan McCollum, two emergency medicine providers, discussing futile care with patients and families. Documentation of discussions is of the essence.