Originally published in KQED.

By Lisa Fine

September 13, 2016

When is more medical care helpful in end-of-life situations and when does it just lead to more suffering? How do you know when it’s time to let someone you love pass away naturally?

These choices are heart-wrenching for patients, families, and their doctors.

A new Netflix documentary short called Extremis, which is Latin for “at the point of death,” follows doctors, patients and their loved ones in various end-of-life scenarios that play out at the intensive care unit at Oakland’s Highland Hospital.

As difficult as these choices are, it’s important to figure out if an intervention will change the course for a patient, said Dr. Jessica Nutik Zitter, the Oakland palliative care physician, who is featured in the documentary.

“Here’s the reality, we are all gonna die,” she says to a group of medical staff in the film’s trailer. “Everyone standing in this room is gonna die one day and it’s good to have a little bit of a say in how.”

Every day, patients are permanently hooked up to machines, she says in the film.

“My concern is we are going to cause more suffering without likely benefit,” she tells a patient’s loved one in the film. “The other approach is let her pass naturally.”

It is often difficult for doctors to fight their instinct to treat medical symptoms and know when it’s time to stop, she wrote about in the New York Times in April.

There is a growing movement within the medical field to recognize how important it is for doctors to help patients navigate care and face the end of their lives.

Boston surgeon Atul Gawande’s recent book and movie called Being Mortal, revealed how well-meaning doctors are often untrained and unprepared to discuss death with their patients.

End-of-life issues have also been at the forefront of public discussion as states like California enact legislation to allow terminally ill patients to take medicines to end their lives.

The Netflix documentary shows how difficult the choices are for families who have to make decisions about a dying loved one.

Giving consent for doctors to stop medical treatment can feel wrong and provoke tremendous feelings of guilt for a patient’s family.

“It would feel like murder to pull her life support,” says one young woman when faced with this choice.

The 24-minute documentary, directed by Dan Krauss, won the Best Documentary Short award this year when it premiered at the 2016 Tribeca Film Festival.


Edited on June 14, 2018.