Managing Conflict at the End of Life

"In tens of thousands of cases each year, patients and families handle catastrophic illness or injury without going to court. They do so with unsung courage, in the face of fear, anguish, and sometimes bitterness. Every loss of a loved one is, in part, a loss of hope — hope for healing of old rifts and fulfillment of thwarted possibilities. Anger and denial are common, especially when relationships were conflict-ridden beforehand. Cast-off parents, rival siblings, children who never measured up to their parents' expectations bring much to the bedside beyond their religious and philosophical leanings

Anger, denial, and other nonrational influences can lock family members into warring stances over whether to treat a devastating illness aggressively or discontinue life-sustaining measures. What is remarkable, given the intensity of the feelings at stake, is how rarely such conflicts make their way to court. It is a measure of how discreetly such squabbles are handled that we know little about how often they arise. And it is a measure of people's character under this pressure that families usually come together to make these judgments or to honor the preferences their loved ones have expressed. ^"

^{Full story in the New England Journal of Medicine}