Technology, futility and palliative care

I witnessed recently the death of a relative on an acute surgical unit. Diagnosed with bladder cancer 2 years previously, her condition had deteriorated slowly during a trip overseas until she returned home and was admitted immediately to hospital for intravenous rehydration, antibiotics and cardiac monitoring. After 2 days her physical condition was considered to have ‘improved’; however, she was also experiencing pelvic pain that responded to a diamorphine infusion. Attempts were made to arrange transfer to a hospice, but this was not possible and she died soon after with her family at hand. Reflecting on these events prompted questions about the relationship between medical technology and the goals of palliative care to ‘avoid overly interventionist treatments and of offering a range of “low-tech” options to people dying with advanced disease’ (Seymour, 2000).