Readers Write: Doing Everything For the Patient, Not To the Patient

Doing Everything For the Patient, Not To the Patient
By Nassib Chamoun

Nassib Chamoun, MS is founder, president, and CTO of Health Data Analytics Institute.

“Do as much as possible for the patient and as little as possible to the patient.”

That single sentence, written by Bernard Lown, MD in “The Lost Art of Healing,” should serve as a universal guide to thinking about medicine, caregiving, and what it truly means to heal. Dr. Lown was my mentor beginning in my early 20s and remained a close friend until his death in 2021 at age 99, He was decades ahead of his time. He believed that medicine should integrate scientific rigor with moral imagination, and that clinical excellence without compassion is incomplete care.

Today, his words feel less like a reflection and more like a challenge. Our population is aging rapidly. Older adults are the fastest-growing consumers of healthcare services.

As more patients approach the later stages of life, the central question facing clinicians, health systems, and policymakers is not whether we can do more, but rather if doing more truly serves the patient. Increasingly, the evidence suggests that quality of life, not simply quantity of life, must be the defining outcome.

This is not a new conversation. In 1974, Balfour Mount, MD, who is widely regarded as the father of palliative care in North America, established the first hospital-based palliative care unit at Montreal’s Royal Victoria Hospital. Since then, the field has grown steadily. Decades of research demonstrate improvements in symptom control, patient and family satisfaction, alignment of care with patient goals, and, in many cases, lower healthcare utilization and costs.

More recently, the World Health Organization issued a call-to-action urging health systems to expand palliative care access. Not only for humanitarian reasons, but also as a sustainable response to the use of our healthcare resources.

Organizations such as the Center to Advance Palliative Care (CAPC) have worked to standardize best practices and train clinicians to deliver high-quality, interdisciplinary palliative care across settings. Leading physician researchers and ethicists have published extensively in peer-reviewed journals, academic texts, and mainstream media.

Despite this robust evidence base, many patients and families still experience end-of-life care as a stark binary: aggressive inpatient interventions on one side, or hospice and “giving up” on the other. Why does this false choice persist?

For me, this question is no longer theoretical. It is deeply personal. As my parents age, I have watched them navigate serious illness, both at home and in the hospital. Again and again, I have seen a system that is reflexively oriented toward intervention — more procedures, more monitoring, and more escalation.

The intent is usually good. But too often the outcome is suffering, including physical discomfort, emotional distress, and a loss of agency at precisely the moment when patients need it most. Where is palliative care in these situations?

End-of-life care should not be an either-or proposition. It should not require patients to choose between life-prolonging treatment that may diminish quality of life or dying at home without support.

Palliative care belongs alongside disease-directed treatment, especially during hospitalizations, where it can provide expert symptom management, clarify goals of care, support families, and guide thoughtful transitions home when appropriate.

I have seen the power of this model first hand. Palliative-focused hospitalizations can be transformative, not only for patients who experience relief from pain and fear, but also for caregivers who gain reassurance, guidance, and partnership. This approach preserves dignity, respects patient values, expands hospital capacity and access, and makes more responsible use of limited healthcare resources. Most importantly, it restores humanity to care.

For me, the conclusion is clear. When possible, our loved ones should not die in hospitals. They also should not have to forgo care, comfort, or hope.

To palliative care clinicians, healthcare leaders, policymakers, advocates, and anyone who has walked this path with someone they love, let us build a healthcare system that truly does everything for the patient, not to the patient. Compassion and evidence are not competing priorities. Together, they form the highest standard of care.