My husband – Tony (left) with his twin brother Adam. Both are internal medicine residents at the University Nebraska Medical Center.

A backyard bar-b-q this Memorial Day weekend with two third year resident physicians – one being my husband and another my brother-in-law (twins who coincidentally (or by design?) have chosen the same career path – see inset picture) prompted a somewhat unique although not unusual conversation considering the company involved: What was everyone’s opinion on life saving measures?

My soon to be (need I say wonderful?) sister-in-law (see below picture showing off the new ring) stated that she wanted all means taken to continue life saving support and that she would want the same for her resident husband. 


My brother-in-law, Adam, with his new fiancé, Kristen. Kristen also works at the University Nebraska Medical Center.

Looking somewhat perturbed by this declaration, my brother-in-law turned to my husband and said that he would trust only my husband to make those types of decisions for him.  And, despite my best assurances that he could trust me with this decision, my husband repeated this same declaration – not to me – but to his brother! 

Although feathers may have been slightly ruffled due to the apparent lack of trust in me and my future sister-in-law’s end of life decision making capabilities, distrust amongst physicians pertaining to life saving measures is apparently nothing new.  A decade long survey by Joseph Gallo of John Hopkins, the results of which are displayed in the below chart, shows what doctors really think about life saving care.  Doctors were given the scenario of “irreversible brain injury without terminal illness” and were then asked what types of treatment they were open to receiving.  chart for doctors


Chalk it up to training and/or the difficult situations doctors witness first hand – the results from this particular study found that when facing irreversible brain injury, doctors don’t want any type of treatment – other than pain meds.   

This sentiment has been more recently addressed by Dr. Ken Murray, a Clinical Assistant Professor of Family Medicine at USC, who has written articles on the apparent gap between the treatment we want doctors to do for us, and the treatment doctors want done for themselves.  According to Dr. Murray, end of life treatment is an “easy” choice to make for most physicians:

“If there is a state of the art of end-of-life care, it is this: death with dignity. As for me, my physician has my choices. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night.”

So, in the light of the above, I guess I won’t take it too personally when my husband would prefer that his brother and fellow physician make this type of difficult decision.   However, because he is married to an attorney, he would be well advised to execute a Health Care Power of Attorney and Advance Directive to ensure his wishes are met.