LIFE or LIMB?- A question that changed my perspective on Medical Treatment.

In 2011, a physician from USC wrote a piece on a rather unusual topic: How Doctors Die? His article presented a novel perspective on an ethical question surrounding end of life care, i.e. how much should clinicians do to save life for terminally ill patients? And his view was inclined towards ‘less is more’. And he mentions the “NO CODE” medallions worn by medical personnel to tell physicians not to perform CPR, because of the very miniscule probability of recovery from CPR and guaranteed destruction of the rib cage. They make a choice, and a well-thought one. Unfortunately, when posed with an end-of-life care decision for my mother, I knew no “NO CODE”. I was asked to choose between saving a limb or saving life. It was a very cruel choice to make.

In the last few decades, medical advances have enhanced longevity significantly, but at the cost of an increased dependence of life on (especially later years) on medical experiences. Longevity in most cases has become a function of medical management. The more, the better! While most times the process of prolonging life with medical management does really well; sometimes it turns nightmarish. In terminally ill cases, we need to make tough decisions. Such decisions are not purely based on medical optimism but also on pragmatic factors such as quality and quantity of life extension. I observe that the medical practice today heavily relies on optimism and believe that any and every condition should be treated.

And I completely disagree. Though I am not entirely sure, I believe that in many cases, the treating physician has a grasp on outcomes for a terminally ill patient. And even in such a situation, physicians keep treating their patients, trying to “fight” death. And this is where the problem is. When faced with the question to choose between amputation of one limb vs. losing life, and that too within 4 hours, I faced the hardest hours of my life. How can you decide? With a very heavy heart, we decided for life and to amputate the leg. After leg amputation, she did not survive and eventually left the world.

The point I am trying to make is that in cases when physicians know survival chances are negligible, they just let the patient be and prepare relatives for the situation rather than posing some inhuman choices. I know it is a complex situation, but let’s hope for more medical maturity from the entire system.

Acknowledgement: I would like to thank Saurabh Gupta for his edits and critique.


Rajaram Iyer
Executive Vice President
Laurus Labs


  1. I can completely relate to this.
    I personally faced a situation wherein a relative was in a ventilator and the doctors came to us and said he can only survive on ventilator, the moment you remove him from ventilator he will die and promptly asked “what do you want to do”, like seriously, they literally put us in die-die situation.
    let’s seriously hope for more medical maturity from the entire system.
    Thank you for sharing!

    1. Hi Hazel, such situations make one realize life’s true value and how complicated medical decisions can be. We can only hope it gets better. Thank you for sharing your story!

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