Advances in medical technology have fuelled unrealistic expectations of the healing power of hospital doctors, says an Australian research fellow.

More than a third of elderly hospital patients received invasive and potentially harmful medical treatments in the last six months of their life, an Australian-led review has found.

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The review's findings, published in the international journal Quality in Health Care, has led to calls for better training of hospital doctors, and for families to start talking about death.

Analysis of 38 studies worldwide found the practice of doctors initiating excessive medical or surgical treatment on elderly patients in the last six months of their life continues in hospitals.

More than 30 per cent of elderly patients with advanced, irreversible chronic conditions were given non-beneficial interventions such as admission to intensive care or chemotherapy in the last two weeks of life, while others who had not-for-resuscitation orders were still given CPR.
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Dr Magnolia Cardona-Morrell says discussing an advanced care treatment plan with your elderly family members now can avoid pain and suffering later.

It is not unusual for family members to refuse to accept the fact that their loved ones is naturally dying of old age and its associated complications and so they pressure doctors to attempt heroic interventions, Dr Cardona-Morrell says.

"This leads to intensive treatments to prolong life and even to resuscitation attempts, which can cause more harm than good.

She also wants doctors to receive better end-of-life training.

Doctors are often torn by the ethical dilemma of saving lives versus respecting a patient's right to die with dignity, she says.

Dr Cardona-Morrell says better hospital training will at least help doctors to let go of the fear of a wrong prognosis, because they will be better able to identify patients near the end of life.

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