willing to undergotherapies they don’t want if thatis
what their loved ones want.
Theoncologistwentto thefather’shometomeet with
him. He had a sheaf of possible trials and treatments
printedfromtheInternet.Shewentthroughthemall.She
was willing to change her opinion,she told him. But
eitherthetreatmentswereforbraintumorsthatwerevery
differentfromhisson’sorelsehedidn’tqualify.None
weregoingtobemiraculous.Shetoldthefatherthathe
neededtounderstand:timewithhissonwaslimited,and
theyoungmanwasgoingtoneedhisfather’shelpgetting
through it.
Theoncologist notedwrylyhowmuch easieritwould
have beenfor her just to prescribe the chemotherapy.
“Butthatmeetingwiththefatherwastheturningpoint,”
shesaid. Thepatientandthefamily optedforhospice.
Theyhad more thana monthtogether beforehe died.
Later,thefatherthankedthedoctor.Thatlastmonth,he
said,thefamilysimplyfocusedonbeingtogether,andit
proved to be the most meaningful time they’d ever spent.
Givenhowprolongedsomeoftheseconversationshave
tobe,manypeoplearguethatthekeyproblemhasbeen
the financial incentives: we pay doctors to give
chemotherapyandtodosurgerybutnottotakethetime
required to sort out when to do so is unwise. This
certainlyisafactor.Buttheissueisn’tmerelyamatterof
financing.Itarisesfromastillunresolvedargumentabout
whatthefunctionofmedicinereallyis—what,inother
words,weshouldandshouldnotbepayingfordoctorsto
do.