08/01/2026
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All care is active. The goals are just different.
Today I was faced with a dilemma.
A patient under my care is nearing the end of life. Frail. Tired. The body already struggling.
There was an infection. It was treated. For a moment, things improved. Then the patient deteriorated again.
Another infection.
Not a failure of treatment, but a body that is no longer able to keep up.
When these moments happen, people often frame the discussion as “active treatment” versus “conservative care.”
But that framing is misleading.
In truth, all care is active care.
The goals are simply different.
Administering or escalating antibiotics is active.
So is actively treating pain, breathlessness, anxiety, agitation, and distress.
So is making sure someone is comfortable, dignified, and not alone.
The question is not whether we are doing something.
The question is what we are doing it for.
In advanced illness, evidence and experience show that repeated antibiotics rarely improve comfort or quality of life. They often add side effects, needles, lines, blood tests, and restlessness. Days may be added, but suffering often comes with them.
Choosing to withdraw antibiotics is not abandonment.
Care does not stop. It shifts.
We actively manage symptoms.
We actively support the family.
We actively protect dignity.
This is not giving up.
This is aligning treatment with reality, and with what truly matters to the patient.
Palliative care is not about doing less.
It is about doing the right things, for the right reasons, at the right time.
If you are facing these decisions with a loved one, know this.
You are not choosing “nothing.”
You are choosing care that is honest, compassionate, and kind.
Speak to me to learn more.