July 2004, Volume 34 Number 7 , p 66 - 67
© 2004 Lippincott Williams & Wilkins, Inc. Volume 34(7) July 2004 p 66–67 Who's crazy now? [INSIGHTS ON DEATH & DYING: PSYCHIATRIC CONSULTS]
A physician I work with routinely orders psychiatric consults for terminally ill patients who ask her to stop aggressive treatments. Do you think that's warranted? —S.S., OHIO
No, I think it's usually an indication that the physician is uncomfortable caring for a patient at the end of life. Some physicians also want to verify and document a patient's competence for legal reasons.
Recently I got a referral to see a patient terminally ill with lung cancer and liver metastasis. His physician wanted me to talk with him about going to rehab so he could get strong enough to tolerate more chemotherapy.
I found my patient lying in bed staring up at the ceiling. I introduced myself as a clinical ...