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Intervention Intervention: Understanding and Managing Our Addiction to Life Saving Interventions

A formal program designed to teach patients & their families the realities surrounding, & the consequences of, life saving interventions.

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Who is your idea designed for and how does it reimagine the end-of-life experience?

Intervention Intervention, is designed for doctors, nurses, social workers, terminal patients & their families. Those with experience (e.g. doctors, EMTs) are far less likely to opt for life saving interventions than the general public. I want to create a formal process that doctors, nurses, & hospital staff can use to explain the consequences of life saving interventions & the benefits of allowing for a natural death, in a way that brings laypeople's decisions in line with an expert's choice.

I was twenty five years old when I watched my father die. The cancer had spread through his body and into his brain. Things had been looking good for a while. My entire family, including my father, insisted that I not come home from law school. And then, seemingly out of nowhere, he started to get very confused. My mom and my brother still told me to stay at school. I called my uncle, the only medical doctor in my family, and he told me it was time to come home. I booked a ticket from Boston to Chicago and came home the next day. When I arrived at the hospital my father was happy to see me, he asked me if I had come straight from court to see him (I hadn't, as I was still in law school), and then he closed his eyes and went to sleep. Those confused words were some of the last words he ever said. The next day he was intubated and moved to the intensive care unit. Food was forced into his stomach with a tube. Air was forced into his lungs with a tube. There were so many tubes. After five excruciating days in the ICU, he finally passed. It was an undignified end for a very dignified man.

He was agitated. He was uncomfortable. He couldn't speak, but it was clear that he was in pain. I watched my mom and my grandparents praying for a miracle. Praying that he would get better. And I found myself, racked with guilt, praying that it would end and that he would find mercy in death. Because everyone in my family didn't want to give up, and wanted to hold out for a miracle, my father spent nearly a week in the ICU - intubated, clearly agitated, and unable to communicate - before he passed.

It didn't have to be that way. He didn't have to suffer. The doctors made it clear, the day they moved him to the ICU, that there was no coming back. However, there is a very stark disconnect between our desire to "do all that we possibly can" and our desire to provide our loved ones with a comfortable and dignified passing.

When I look back on my experience, There were so many things wrong. 1. I shouldn’t have had to feel guilty about wishing for a merciful ending for my father. 2. The rest of my family should have been clearly informed of the reality, that there was virtually a zero percent chance of the miracle they were praying for, and that to keep someone alive with such low quality of life is cruel.

Healthcare professionals understand this themselves, and as such, they are much less likely to opt for life saving interventions than members of the general public. There is a fantastic episode of RadioLab that covers this exact subject ( 

I would like to design a standardized training program for doctors, nurses, and hospital social workers to teach them how to better explain end of life choices to patients and their families. It would be data-driven, and designed to gently and compassionately bring the decisions of patients and their families more in line with the decisions of experts in the realm of life saving interventions, without making them feel guilty about their decision. 

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

Train the staff at a local hospital in clearly communicating the consequences surrounding end of life interventions and the benefits of allowing for a dignified death. Poll both the staff and the patient families, after the fact, to see how their experience differed from the experiences at a hospital that doesn't have a standardized program to explain the realities of life saving interventions.

What skills, input or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

I think the OpenIDEO community could provide a lot of help in designing the nuts and bolts of the actual program. Changing deeply held beliefs regarding end of life choices will certainly be difficult, and it will require a lot of expertise to put together a program that can: (a) identify the best way to persuasively communicate the realities of life saving interventions such that patients choices come more in line with expert opinion, (b) train doctors in said communication.

Tell us about your work experience:

I'm a non-practicing attorney. I currently work as the director of a tech start-up incubator / co-working space in Chicago. I have no background in design, but I do have a great passion for it, specifically UX design.

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Photo of Yuan Wang

Really good angle. There's so much to be explored in this idea. To build upon it, I think the scope can even be broader, apart from patients and families, everyone of us can learn to plan ahead and make that decision when we are capable of, rather than leaving that to our loved ones. 

Photo of Sam

Hey Yuan, thanks for your comment! I totally agree. General end of life planning is really important and most people put it off until it is too late. It seems that people only consider these things at an inflection point in their life (e.g. marriage or childbirth), but even if they consider it briefly, they don't act on it. 

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