In any event, a clinical depression is always a condition to treat appropriately and adequately. There is no lack of data that cancer patients who express wishes to die no longer express these wishes when pain medication is adequate or when effective antidepressant therapy has been achieved. As if hospitals were filled with beds and wards of not quite human carrots on life-support systems. The patient's helplessness and dependency may provoke fears of engulfment in the doctor, and the distressing daily reminder of the patient's downhill course may promote physicians' tendencies to distance themselves from the patient. This may lead to unconscious withdrawal from, or rejection of, the patient.
Imperceptive thoughts dictate many of our decisions.
And with the advent of mangled care organizations, the pocketbook value of sustaining life must be factored into the equation. MC2, where MC is managed care, and the exponent is the pressure on physicians not to treat. And the pressure is real. The gatekeeper physicians are under the gun not to refer to specialists-unless there is no other choice. The Right to Choose Yes.